Ricci Lorenzo, Motolese Francesco, Tombini Mario, Lanzone Jacopo, Rea Roberta, Di Matteo Francesco, Di Lazzaro Vincenzo, Assenza Giovanni
Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, University Campus Bio-Medico of Rome, via Álvaro del Portillo 21, 00128 Rome, Italy.
Digestive Endoscopy Unit, Department of Medicine, University Campus Bio-Medico of Rome, via Álvaro del Portillo21, 00128 Rome, Italy.
Brain Sci. 2020 Apr 10;10(4):227. doi: 10.3390/brainsci10040227.
Metronidazole-induced encephalopathy (MIE) is a rare and often under-recognized iatrogenic condition. The diagnosis should be considered in metronidazole-treated patients presenting with acute encephalopathy, unprovoked seizures and cerebellar signs. While typical magnetic resonance imaging (MRI) findings strongly support the diagnosis, electroencephalography (EEG) features have been rarely reported and poorly described. We present a longitudinal EEG assessment in one patient with encephalopathy due to metronidazole toxicity who presented a peculiar EEG pattern presentation and evolution. During the acute phase of encephalopathy, the EEG showed a monomorphic, sharply contoured theta activity symmetrically represented over frontal regions with an anterior-posterior progression which evolved in parallel with clinical worsening. Together with a systematic review of the literature, we discuss whether this EEG activity may represent a distinct neurophysiological correlate of 'cerebellar encephalopathy'.
甲硝唑诱发的脑病（MIE）是一种罕见且常未被认识的医源性疾病。对于接受甲硝唑治疗后出现急性脑病、不明原因癫痫发作和小脑体征的患者，应考虑该诊断。虽然典型的磁共振成像（MRI）表现强烈支持该诊断，但脑电图（EEG）特征很少被报道且描述不佳。我们对一名因甲硝唑毒性导致脑病的患者进行了纵向脑电图评估，该患者呈现出独特的脑电图模式表现及演变过程。在脑病急性期，脑电图显示在额叶区域对称出现单形、轮廓清晰的θ活动，并从前向后进展，其与临床病情恶化同步演变。结合对文献的系统回顾，我们讨论了这种脑电图活动是否可能代表“小脑性脑病”的一种独特神经生理关联。
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