Hwang Gi Hoon, Sim Young-Joo, Jeong Ho Joong, Kim Ghi Chan, Sin Bae Wook, Jung Ju Ho
Department of Physical Medicine and Rehabilitation, Kosin University College of Medicine, Busan, Korea.
Department of Neurosurgery, Kosin University College of Medicine, Busan, Korea.
Korean J Spine. 2012 Mar;9(1):44-8. doi: 10.14245/kjs.2012.9.1.44. Epub 2012 Mar 31.
Metronidazole may produce a number of neurologic side effects including peripheral neuropathy, seizure, encephalopathy. We experienced neurological side effects of metronidazole. The 32-year-old female patient with spinal cord injury was diagnosed as encephalophathy and peripheral polyneuropathy resulting from complication of metronidazole. It was difficult to diagnose at first glance using clinical findings because of paraplegia due to spinal cord injury. But through magnetic resonance imaging with diffusion weighted imaging and electrophysiologic study, the patient showed to have characteristic abnormalities that of a person suffering from metronidazole-induced encephalopathy and peripheral polyneuropathy. Whether the symptoms were caused by a peripheral nerve lesion or MIE, the patient's paraplegia prevented to appear other symptoms, such as ataxic gait and seizure, from manifesting. In such case as this, an active differentiated diagnosis is crucial.
甲硝唑可能会产生多种神经系统副作用，包括周围神经病变、癫痫发作、脑病。我们遇到了甲硝唑的神经系统副作用。这位32岁的脊髓损伤女性患者被诊断为甲硝唑并发症导致的脑病和周围性多发性神经病。由于脊髓损伤导致截瘫，乍一看很难根据临床症状进行诊断。但通过磁共振成像弥散加权成像和电生理研究，该患者显示出具有甲硝唑诱导的脑病和周围性多发性神经病患者的特征性异常。无论症状是由周围神经病变还是甲硝唑诱导的脑病引起，患者的截瘫都使得其他症状，如共济失调步态和癫痫发作，无法表现出来。在这种情况下，积极的鉴别诊断至关重要。
