Metronidazole-induced central and peripheral nervous system toxicity
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Metronidazole is a commonly prescribed antiprotozoal and antibacterial agent. Common adverse effects include nausea, headache and metallic taste . There are reports of nervous system toxicity, with cerebellar syndrome and neuropathy most frequently described and encephalopathy and seizures less commonly .
We describe a woman who developed sequential peripheral and central nervous system (CNS) toxicity, after metronidazole treatment. We discuss the pathophysiology of metronidazole-induced neurotoxicity and review reported cases.
We report a 37 years old woman with Crohn’s disease who was submitted to small bowel resection. Afterwards she was started on vitamins (B12, folic acid) and prophylactic antibiotics (ciprofloxacin 400 mg/day, metronidazole 1500 mg/day). Three months later, she developed lower limbs numbness and paresthesia, which progressed to involve upper limbs in a few days. In 2 weeks slurred speech and marked gait instability appeared....
KeywordsMetronidazole Neurotoxicity Peripheral neuropathy Cerebellar ataxia
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.