MR imaging and diffusion-weighted imaging changes in metronidazole (Flagyl)-induced cerebellar toxicity

AJNR Am J Neuroradiol. 2003 Sep;24(8):1615-7.

Abstract

We describe a case demonstrating reversible MR imaging findings, including diffusion-weighted imaging changes in association with metronidazole (Flagyl) toxicity. The diagnosis of metronidazole toxicity was made clinically and supported by the MR imaging findings. Quantitative apparent diffusion coefficient (ADC) maps demonstrated edema with associated increased ADC values within the dentate nuclei of the cerebellum on initial imaging. Follow-up imaging performed 8 weeks after cessation of metronidazole therapy demonstrated resolution of imaging findings, including diffusion changes.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Abscess / drug therapy*
  • Abdominal Neoplasms / complications
  • Abdominal Neoplasms / secondary*
  • Aged
  • Amoxicillin / administration & dosage
  • Anti-Infective Agents / administration & dosage
  • Anti-Infective Agents / toxicity*
  • Carcinoid Tumor / complications
  • Carcinoid Tumor / secondary*
  • Cerebellar Ataxia / chemically induced*
  • Cerebellar Ataxia / diagnosis
  • Cerebellar Nuclei / drug effects
  • Cerebellar Nuclei / pathology
  • Diffusion Magnetic Resonance Imaging*
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Drug Therapy, Combination / administration & dosage
  • Drug Therapy, Combination / toxicity*
  • Dysarthria / chemically induced*
  • Dysarthria / diagnosis
  • Follow-Up Studies
  • Humans
  • Image Processing, Computer-Assisted*
  • Magnetic Resonance Imaging*
  • Male
  • Metronidazole / administration & dosage
  • Metronidazole / toxicity*
  • Neurotoxicity Syndromes / diagnosis*
  • Ofloxacin / administration & dosage
  • Remission, Spontaneous

Substances

  • Anti-Infective Agents
  • Metronidazole
  • Amoxicillin
  • Ofloxacin