Serviço de Imagiologia Neurológica, Unidade Local de Saúde Santa Maria, Lisboa, Portugal.
Faculdade de Medicina da Universidade de Lisboa, Clínica Universitária de Imagiologia, Lisboa, Portugal.
Clin Toxicol (Phila). 2024 Sep;62(9):598-600. doi: 10.1080/15563650.2024.2385683. Epub 2024 Aug 7.
Metronidazole-induced encephalopathy is an uncommon but potentially severe complication of metronidazole treatment. Although the exact pathophysiology remains elusive, proposed hypotheses include RNA binding, neurotoxicity from free radicals, and modulation of neurotransmitter receptors. Most cases demonstrate improvement upon discontinuation of metronidazole, highlighting the importance of early recognition. Magnetic resonance imaging plays a critical role in diagnosing metronidazole-induced encephalopathy, with characteristic imaging findings frequently observed in the dentate nuclei and corpus callosum.
A 63-year-old man treated with metronidazole for lumbar spondylodiscitis developed neurological symptoms consistent with metronidazole-induced encephalopathy.
Magnetic resonance imaging revealed characteristic bilateral hyperintense lesions in the cerebellar dentate nuclei, corpus callosum, and brainstem. Prompt recognition and discontinuation of metronidazole led to symptom resolution.
This case underscores the importance of clinicians and radiologists being aware of this condition and emphasizes the pivotal role of magnetic resonance imagining in establishing the diagnosis.
甲硝唑诱导性脑病是甲硝唑治疗的一种罕见但潜在严重的并发症。尽管确切的病理生理学仍不清楚，但提出的假说包括 RNA 结合、自由基引起的神经毒性和神经递质受体的调节。大多数病例在停止使用甲硝唑后有所改善，这凸显了早期识别的重要性。磁共振成像在诊断甲硝唑诱导性脑病中起着关键作用，在齿状核和胼胝体中常观察到特征性的影像学表现。
一名 63 岁男性因腰椎脊椎炎接受甲硝唑治疗，出现与甲硝唑诱导性脑病一致的神经症状。
磁共振成像显示小脑齿状核、胼胝体和脑干双侧高信号病变。及时识别并停止使用甲硝唑导致症状缓解。
本病例强调了临床医生和放射科医生了解这种情况的重要性，并强调了磁共振成像在确立诊断中的关键作用。
