A case of metronidazole-induced central and peripheral nervous system complications

Metronidazole is a commonly used antibiotic with potent activity against anaerobic bacteria and protozoa. It is believed to cross bloodbrain-barrier and penetrate central nervous system easily. While metronidazole is fairly safe and well tolerated, it can rarely cause serious neurological adverse events, including peripheral neuropathy, cerebellar dysfunction, ototoxicity, seizures, visual impairment, and encephalopathy [1,2]. It has been suggested that neurological toxicity may be related to prolonged administration, high doses, or high cumulative doses of metronidazole [3]. Here we report clinical course, MRI as well as electrodiagnostic findings consistent with concurrent central nervous system (CNS) and peripheral nervous system (PNS) complications in a patient on metronidazole.