Cerebellar ataxia after a single day of metronidazole use: Case report

Cerebellar ataxic syndromes, although uncommon, have been reported previously in patients taking metronidazole. However, almost all cases describe instances where were prolonged or high doses of the drug. We report a 65-year-old man who consumed 400 mg metronidazole 3 times over 1 day and presented with slurring speech, imbalance while walking diplopia. The symptoms developed after consumption Examination showed gaze-evoked nystagmus, dysmetria limbs. MRI brain revealed symmetric hyperintense lesions dentate nucleus pons on T2-weighted imaging FLAIR, which well-established association metronidazole-induced central nervous system (CNS) toxicity. On discontinuation drug, improved, complete recovery was noted at follow-up 2 weeks later. This case indicates that CNS side effects may not necessarily occur only courses metronidazole, but as an idiosyncratic reaction to Reasons for variable susceptibility require further investigation.