Quiz Form

Question Date: 03/11/2023

Question: A 56-year-old man with a history of treated liver abscess 1 month ago presents with vertigo, gait ataxia and tremors. MRI is as shown below. What is the diagnosis?

Options:

• Brain Abscess
• Post infectious demyelination
• Metronidazole toxicity
• FXATS

Correct Answer: Metronidazole toxicity

View Image: Image_202310310723096540ab5d90951.jpg

Explaination: Metronidazole is well known to cause brain toxicity irrespective of the dose and duration of intake<br>Neurologic toxicity has been reported, especially if the dosage exceeds 2 grams per day for a prolonged period or if the cumulative dose exceeds 20 gramsIn<br> an acute setting, metronidazole toxicity typically presents with cerebellar dysfunction (75% of cases), confusion and altered sensorium (33%), and seizures (13%). On MR imaging, 93100% of cases show involvement of the cerebellum, particularly at the dentate nuclei regions<br>The corpus callosum, midbrain, pons, and medulla are among the less-involved locations.

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