Karayianni Marina, von Heijne Anders, Laska Ann-Charlotte
Danderyds Sjukhus AB - Internal medicin Stockholm, Sweden Danderyds Sjukhus AB - Internal medicin Stockholm, Sweden.
Danderyds sjukhus - Röntgenavd Stockholm, Sweden Danderyds sjukhus - Röntgenavd Stockholm, Sweden.
Lakartidningen. 2017 Mar 20;114:ECUU.
Encefalopathy as a side effect of metronidazole therapy - a case report Neurological symptoms as side effects of pharmacological treatment generally tend to remain underdiagnosed. In this report, we present a case of a 79 year old patient that developed encephalopathy whilst undergoing prophylactic treatment with Metronidazole. The initial presentation of disseminated neurological symptoms lead to the suspicion of a cerebrovascular lesion. However, exacerbation of symptomatology with gait disturbance, ataxia and dysarthria challenged the preliminary diagnosis. Brain magnetic resonance imaging (MRI) demonstrated T2 hyper-intensity over bilateral dentate nuclei. A drug history revealed that the patient had been treated with Metronidazole daily for several weeks due to a surgical condition. Cessation of the drug provided reversal of symptoms and radiological findings upon follow up MRI. This case report aims at increasing awareness regarding side effects of Metronidazole as well as early detection in patients who present with neurological symptoms.
甲硝唑治疗引发的脑病——病例报告 作为药物治疗的副作用，神经症状通常容易被漏诊。在本报告中，我们呈现了一例79岁患者在接受甲硝唑预防性治疗时发生脑病的病例。最初出现的弥散性神经症状引发了对脑血管病变的怀疑。然而，步态障碍、共济失调和构音障碍等症状的加重对初步诊断提出了挑战。脑部磁共振成像（MRI）显示双侧齿状核T2高信号。用药史显示，由于外科疾病，该患者已连续数周每日接受甲硝唑治疗。停药后，后续MRI检查显示症状和影像学表现均有改善。本病例报告旨在提高对甲硝唑副作用的认识以及对出现神经症状患者的早期检测。
