Ferroir J-P, Corpechot C, Freudenreich A, Khalil A
hôpital Tenon, Paris, France.
Rev Neurol (Paris). 2009 Oct;165(10):828-30. doi: 10.1016/j.neurol.2008.10.026. Epub 2009 Feb 12.
Neurological complications of metronidazole are rare, predominantly peripheral neuropathies, especially in patients on a long-term high-dose regimen. Cerebellar syndrome or seizures are less frequently reported. The concomitant occurrence of the three complications is exceptional.
We report herein a case with these three complications as side effects of metronidazole. For the cerebellar syndrome, the T2-weighted brain MRI showed a rounded and well-delimited zone of high signal intensity in the cerebellar dentate nuclei, extending up to the protuberance and the subthalamic nucleus, bilaterally and symmetrically.
Neurological complications are possible when a treatment with metronidazole is prescribed for a long duration or at high dose. In our patient, the clinical abnormalities and MRI signs regressed a few months after treatment withdrawal.
甲硝唑的神经并发症罕见,主要为周围神经病变,尤其是长期接受高剂量治疗方案的患者。小脑综合征或癫痫发作的报告较少。这三种并发症同时出现的情况极为罕见。
我们在此报告一例出现这三种并发症作为甲硝唑副作用的病例。对于小脑综合征,脑部T2加权磁共振成像显示小脑齿状核有一个圆形且边界清晰的高信号强度区域,双侧对称地延伸至小脑蚓部和丘脑底核。
长期或高剂量使用甲硝唑进行治疗时可能出现神经并发症。在我们的患者中,停药几个月后临床异常和磁共振成像征象消退。