Garbled speech: a rare presentation of metronidazole-induced neurotoxicity

Cheema, Muhammad Arslan; Salman, Fnu; Ullah, Waqas; Zain, Muhammad

doi:10.1136/bcr-2018-227804

Cited by 7 publications

(4 citation statements)

References 10 publications

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“…In addition, the superior and inferior olivary complex, bilateral cerebral hemispheres (subcortical) white matter, basal ganglia, and thalamus were uncommon sites (Figure 5). As per the already published 10 cases of metronidazole neurotoxicity [7][8][9][10][11][12][13][14][15][16], the dentate nuclei are the common sites of involvement on MRI. All cases from our study and nine of the 10 earlier documented cases involved dentate nuclei.…”

Section: Discussionmentioning

confidence: 93%

MRI Findings and Topographic Distribution of Lesions in Metronidazole-Induced Encephalopathy

Fatima¹,

Khanduri²,

Sultana³

et al. 2022

Cureus

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Section: Discussionmentioning

confidence: 93%

MRI Findings and Topographic Distribution of Lesions in Metronidazole-Induced Encephalopathy

Fatima¹,

Khanduri²,

Sultana³

et al. 2022

Cureus

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“…Central nervous system symptoms are potentially reversible, usually improving within a few days, and symptoms may disappear within weeks [12], in contrast to what has been observed with symptoms of polyneuropathy [5,10]. When the CNS is affected, typical image findings include symmetrical T2/FLAIR hyperintensities of the dentate nuclei, dorsal aspect of the pons, medulla, genu, and splenium of the corpus callosum [9], and one study suggests an electroencephalogram (EEG) pattern-a marked theta activity with progressive anteroposterior diffusion [13].…”

Section: Discussionmentioning

confidence: 97%

“…Metronidazole, an antibiotic and antiprotozoal drug that passes freely through the blood-brain barrier [5], is neurotoxic and can affect the central nervous system (CNS)-presenting as ataxia, altered mental status, dysarthria, as well as, with lower frequency, seizures, encephalopathy, cerebellar dysfunction [5,8] and slurred speech [9]. It can also affect the peripheral nervous system, causing peripheral neuropathy, although it is considered a rare condition, four times less frequent than CNS impairment [10,11].…”

Section: Discussionmentioning

confidence: 99%

Sensory-motor polyneuropathy due to the use of antiparasitic drugs: A case report

Orsini Neves,

Cwajgenberg,

Pereira

et al. 2023

Int J Case Rep Images

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Introduction: The term polyneuropathy refers to a generalized involvement of peripheral nerves, usually involving mainly the distal nerves and, more often, presenting with sensory, motor, and autonomic symptoms and clinical findings. Drug-induced peripheral neuropathy (DIPN) is a persistent condition, most often associated with anticonvulsants, chemotherapy, cardiovascular, psychotropic, and antimicrobial drugs, such as Metronidazole. In this article, we report the case of a patient who developed polyneuropathy secondary to the use of Metronidazole. Case Report: D.D.S.L., a 45-year-old female, previously healthy, presented with abdominal discomfort. Entamoeba histolytica was detected after investigation, and she started a 7-day cycle of 500 mg of Metronidazole three times a day for seven days, without clinical response. A new therapeutic approach was attempted, with three cycles of 2 grams of Secnidazole single dose and Tinidazole for four weeks. However, the patient presented dysesthesia in the distal third of the thighs, followed by allodynia in the four limbs and trunk. After new abdominal discomfort, three months after the first medication cycle, another pharmacological cycle was started. Neurological examination and electroneuromyography (ENM) examination suggested axonal sensorimotor polyneuropathy in all four limbs. Conclusion: Polyneuropathy can be caused by many factors, including some frequently prescribed drugs such as Metronidazole and other medications in the 5-nitroimidazole group. Therefore, although the relationship between these drugs and polyneuropathy is not fully elucidated, their neurotoxicity is indisputable, even in rare cases, but with significant variability in terms of the dose-dependent potential for this disease.

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“…Cities are in the transitional stage and are faced with mass of challenges in Pakistan. Cheema, (2009)urgedthatthesechallengesaredirectlyrelatedtothechanginglandusepatternswithincities. Recently,thegovernmenthascomeoutinfavoroftallbuildinginmajorcities.Ironicallyhigh-rise buildingsarealsocontinuinginthenearvicinityofairportstoo.Residentialareasabuttingalong transportationroutesincitiesareatsuccessionduetocommercialization.Mostly,highrisecommercial establishmentandofficeenclavearereplacingpreviousresidentialareas (Zhao,P.andLu,B.,2009).…”

Section: -Spatial Growth and Air Pollution In Cities Of Pakistanmentioning

confidence: 99%

City Growth Patterns Intensifying Complexities to Control Vehicular Exhaust Pollution in Pakistan

Ahmad

2022

International Journal of Urban Planning and Smart Cities

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Unplanned constructions of high-rise buildings are continuing to fulfill the demand for commercialization in cities. This change in land use has overlooked to consider the associated infrastructure. Beside other problems, it thoroughly escalates vehicular movement and makes the environment more vulnerable. Symptomatic approaches from the government continue but could not succeed to avert the danger permanently. This research has examined circulation pattern and traffic flow on major roads of the city. Beside it, the performance of Vehicle Emission Testing Station is reviewed. The author found that disproportionate change in land use has intensified vehicular movement and the crammed road network spoiled all the curative measures. A professional’s interviews were carried out to understand the problem. During professional discussion many things were found missing within the management system of the city. Therefore, the researcher developed a systematic approach/model to incorporate all aspects of the missing components in order to curb air pollution effectively in cities.

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Garbled speech: a rare presentation of metronidazole-induced neurotoxicity

Cited by 7 publications

References 10 publications

MRI Findings and Topographic Distribution of Lesions in Metronidazole-Induced Encephalopathy

MRI Findings and Topographic Distribution of Lesions in Metronidazole-Induced Encephalopathy

Sensory-motor polyneuropathy due to the use of antiparasitic drugs: A case report

City Growth Patterns Intensifying Complexities to Control Vehicular Exhaust Pollution in Pakistan

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