Metronidazole, an Uncommon Cause of Dizziness and Ataxia in the Emergency Department: A Case Report

Introduction: Metronidazole, a nitroimidazole antibiotic, is well-known antibacterial and antiprotozoal agent that generally well tolerated without many serious side effects. Most adverse reactions affect the gastrointestinal or genitourinary system, but central nervous system may also be afflicted. In addition to headache dizziness, cerebellar dysfunction can occur with metronidazole use. Case Report: We discuss clinical presentation imaging findings of metronidazole-induced encephalopathy in 12-year-old male. The patient had history Crohn’s disease chronic Clostridium difficile infection for which he received approximately 75 days prior arrival local emergency department (ED). He presented five progressive vertigo, nausea, vomiting, ataxia. Subsequent magnetic resonance showed symmetric hyperintense dentate nuclei lesions, characteristic encephalopathy. patient’s symptoms improved rapidly after cessation metronidazole, his completely resolved by discharge on hospital day two. Conclusion: Metronidazole-induced rare cause vertigo ataxia lead permanent sequela if not identified treated promptly. Thus, it important physicians keep this diagnosis mind when evaluating patients who present ED new neurologic complaints.