Review article

ENCEPHALOPATHY CAUSED BY THE APPLICATION OF METRONIDAZOLE

IVETA MERĆEP ; University of Zagreb, School of Medicine, Zagreb; Zagreb University Hospital Centre, Department of Internal Medicine, Zagreb, Croatia
MARINA TITLIĆ ; University of Split, School of Medicine, Split; Split University Hospital Centre, Department of Neurology, Split, Croatia
ANA ĆURKOVIĆ KATIĆ ; Split University Hospital Centre, Department of Neurology, Split, Croatia
ANA REPIĆ BULIČIĆ ; Split University Hospital Centre, Department of Neurology, Split, Croatia
NIKOLINA FRIŠČIĆ ; Zagreb University Hospital Centre, Department of Internal Medicine, Zagreb, Croatia

Abstract

Metronidazole is an antibiotic used for treating anaerobic bacterial and parasitic infections. A rare side effect of using this drug is encephalopathy. The most commonly observed symptoms include dysarthria, gait instability, and/or ataxia. Metronidazole induced encephalopathy should be differentiated from other possible causes of encephalopathy. Clinical picture with data on metronidazole application, as well as magnetic resonance imaging (MRI) of the brain, T2 and FLAIR sequences, neurological diagnostic procedures such as electroencephalography (EEG), laboratory tests and lumbar puncture should be performed. Typical brain MRI fi ndings in T2 and FLAIR technique show hyperintensity, which in most cases affects dentate nucleus of the cerebellum, parts of brainstem, and splenium corporis callosi. Genetic testing is sometimes required to distinguish some rare causes of encephalopathy. Neurological changes due to metronidazole application are most often reversible and vanish after metronidazole withdrawal. Use of methylprednisolone in treating this type of encephalopathy is sometimes helpful.

Keywords

metronidazole; side effects; encephalopathy

Hrčak ID:

261268

URI

https://hrcak.srce.hr/261268

Publication date:

10.8.2021.

Article data in other languages: croatian

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