Metronidazole, a commonly used antibiotic drug, can cause adverse effects in the central nervous system termed metronidazole-induced encephalopathy, leading to diagnostic challenges. The condition is rare and a detailed description of its phenotype is lacking. In this systematic review we investigated the clinical features of metronidazole-induced encephalopathy to promote recognition and elaborate the description. We performed a systematic literature search using PubMed.gov and hand searched the reference lists of included articles and other publications of interest. We included case series and single reports describing individual patients developing symptoms from the central nervous system in relation to metronidazole treatment. Data were extracted and analyzed descriptively. We identified 779 publications of which 112 papers comprising 136 patients were included. Typical findings were dysarthria, gait instability, limb dyscoordination and altered mental status. Frequently, patients concomitantly presented with metronidazole-induced polyneuropathy. Liver disease was the most common pre-existing condition. MRI showed a characteristic pattern of reversible symmetrical hyperintense lesions on T2/FLAIR of the dentate nuclei in 90% of patients. Most patients improved significantly after discontinuation of metronidazole. Poor outcome was associated with severe comorbidity. Metronidazole-induced encephalopathy should be considered in patients presenting with neurological symptoms in relation to newly initiated or prolonged metronidazole treatment. MRI changes are highly characteristic and specific. Patients with liver disease are at increased risk. Prognosis is good if recognized early.

https://link.springer.com/content/pdf/10.1007/s00415-018-9147-6.pdf

Metronidazole-induced encephalopathy: a systematic review

Metronidazole-induced encephalopathy is a rare neurologic adverse effect of an antibiotic drug ‘metronidazole’. Although it is usually reversible with immediate cessation of the drug, it can also be fatal when used continuously. Here, we present a 72- year-old female who was on metronidazole for a total of 46 consecutive days. Her initial MRI on the 22nd day of medication use revealed a typical involvement of the cerebellar dentate nuclei, corpus callosum splenium, and periaqueductal midbrain, suggesting metronidazole-induced encephalopathy. However, she continued the medication for another 24 days, until she revisited our emergency department with mental status change. Her consecutive MRI showed diffuse cerebral and brainstem involvement, as well as a more prominent involvement of the dentate nuclei and splenium. We present this case to highlight that it is possible for metronidazole-induced toxic encephalopathy to worsen without immediate withdrawal of the offending drug.

Metronidazole induced encephalopathy: a case report showing devastating course on consecutive MR imaging.

Metronidazole, a commonly used antibiotic, is a drug of the family of 5-nitroimidazoles, which has antiparasitic and antibacterial properties in anaerobic organisms. A number of side effects to its use has been described, rare adverse effects also has been reported, included Metronidazole Induced Encephalopathy (MIE). MIE is potentially reversible neurological disorder. It is characterized by central and peripheral neurological disorders such as dysarthria, disturbances in consciousness, ataxic gait, paraesthesia, polyneuropathy, and less frequently seizures occur. The diagnosis is based on the clinic, identifying the history of consumption of Metronidazole and evidencing hyperdense images at the level of the dentate ganglia on a nuclear magnetic resonance imaging of the skull, with reversal of the picture after suspending the consumption of Metronidazole. It is important not only to identify the clinical picture to suspend the consumption of this drug, also, it is necessary inform to patients about the possible adverse effects of Metronidazole use, included MIE.

Encefalopatía inducida por Metronidazol

Metronidazole is a well-known antimicrobial agent, used for the treatment of anaerobic bacterial and protozoal infections. It is generally well tolerated with common side effects like nausea, dizziness, headache and metallic taste in the mouth. But prolonged use of metronidazole can cause neurotoxicity like ataxic gait, dysarthria, seizures and encephalopathy. Here, we are reporting a case of a 60 years old male patient who was a chronic alcoholic with liver abscess and he developed acute ataxia and dysarthria after four weeks use of metronidazole. The causality of metronidazole in this case was “probable” with score 7 as per Naranjo scale. The patient was managed by discontinuing the metronidazole and there was considerable improvement in his gait and speech after that. The case was recorded properly in adverse drug reaction reporting form and was sent to nearby adverse drug reaction (ADR) monitoring centre.

https://www.ijbcp.com/index.php/ijbcp/article/download/5323/3559

Metronidazole induced neurotoxicity: a case report

An economic analysis of capsicum production in Haryana under different protected structures has been done in the present study. Sonepat, Karnal and Hisar districts were purposively selected as cultivation under all types of protected structures (natural ventilated polyhouses, net houses, and walk-in-tunnels) is practice in these districts. The results obtained in this study indicated that the naturally ventilated polyhouse has the highest total cost (Cost C2) incurred on capsicum in the district of Sonepat followed by Hisar and Karnal. Net returns were found highest in Karnal district followed by Hisar and Sonepat, respectively. B:C ratio was found highest in Karnal among all these three selected districts. In case of net house, the highest total cost incurred on capsicum in Karnal district followed by the districts of Sonepat and Hisar. However, Hisar district gave the highest net returns followed by Karnal and Sonepat. B:C ratio was found highest in Hisar as compared to Sonepat and Karnal districts, while, in walk-in-tunnel structures, highest total cost incurred on capsicum in Sonepat district among all districts. Net returns were found highest in Sonepat district in comparison to all districts. B:C ratio was equal recorded in Sonepat and Hisar district. It was calculated from the study that producer's share in consumer rupee was found highest in market channel-III (producer to direct consumer) which was proved to be most efficient channel in marketing of capsicum.

Comparative Profitability of Capsicum (capsicum Annuum) Cultivation under Different Protected Structures in Haryana

Metronidazole is a commonly used drug and considered relatively safe. But it may present with neurotoxicity, commonly peripheral and rarely central. We report here a case of a young patient with amoebic liver abscess who continued taking metronidazole longer than the prescribed duration of the drug and developed peripheral neuropathy and cerebellar neurotoxicity which was reversible after discontinuation of the drug.

http://www.ijhpd.com/archive/2016-archive/100061IJHPDRZ2016-kumari/100061IJHPDRZ2016-kumari.pdf

Metronidazole induced neurotoxicity in a case of liver abscess

Reversible dilated cardiomyopathy in a case of primary hypothyroidism

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Dilip Kumar

Author Tools

Chat about Author

Papers

Metronidazole induced neurotoxicity in a case of liver abscess

Reversible dilated cardiomyopathy in a case of primary hypothyroidism