Cargando…
Metronidazole Encephalopathy EEG Features: A Case Report with Systematic Review of the Literature
Metronidazole-induced encephalopathy (MIE) is a rare and often under-recognized iatrogenic condition. The diagnosis should be considered in metronidazole-treated patients presenting with acute encephalopathy, unprovoked seizures and cerebellar signs. While typical magnetic resonance imaging (MRI) fi...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7226540/ https://www.ncbi.nlm.nih.gov/pubmed/32290116 http://dx.doi.org/10.3390/brainsci10040227 |
_version_ | 1783534312535097344 |
---|---|
author | Ricci, Lorenzo Motolese, Francesco Tombini, Mario Lanzone, Jacopo Rea, Roberta Di Matteo, Francesco Di Lazzaro, Vincenzo Assenza, Giovanni |
author_facet | Ricci, Lorenzo Motolese, Francesco Tombini, Mario Lanzone, Jacopo Rea, Roberta Di Matteo, Francesco Di Lazzaro, Vincenzo Assenza, Giovanni |
author_sort | Ricci, Lorenzo |
collection | PubMed |
description | Metronidazole-induced encephalopathy (MIE) is a rare and often under-recognized iatrogenic condition. The diagnosis should be considered in metronidazole-treated patients presenting with acute encephalopathy, unprovoked seizures and cerebellar signs. While typical magnetic resonance imaging (MRI) findings strongly support the diagnosis, electroencephalography (EEG) features have been rarely reported and poorly described. We present a longitudinal EEG assessment in one patient with encephalopathy due to metronidazole toxicity who presented a peculiar EEG pattern presentation and evolution. During the acute phase of encephalopathy, the EEG showed a monomorphic, sharply contoured theta activity symmetrically represented over frontal regions with an anterior–posterior progression which evolved in parallel with clinical worsening. Together with a systematic review of the literature, we discuss whether this EEG activity may represent a distinct neurophysiological correlate of ‘cerebellar encephalopathy’. |
format | Online Article Text |
id | pubmed-7226540 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-72265402020-05-18 Metronidazole Encephalopathy EEG Features: A Case Report with Systematic Review of the Literature Ricci, Lorenzo Motolese, Francesco Tombini, Mario Lanzone, Jacopo Rea, Roberta Di Matteo, Francesco Di Lazzaro, Vincenzo Assenza, Giovanni Brain Sci Review Metronidazole-induced encephalopathy (MIE) is a rare and often under-recognized iatrogenic condition. The diagnosis should be considered in metronidazole-treated patients presenting with acute encephalopathy, unprovoked seizures and cerebellar signs. While typical magnetic resonance imaging (MRI) findings strongly support the diagnosis, electroencephalography (EEG) features have been rarely reported and poorly described. We present a longitudinal EEG assessment in one patient with encephalopathy due to metronidazole toxicity who presented a peculiar EEG pattern presentation and evolution. During the acute phase of encephalopathy, the EEG showed a monomorphic, sharply contoured theta activity symmetrically represented over frontal regions with an anterior–posterior progression which evolved in parallel with clinical worsening. Together with a systematic review of the literature, we discuss whether this EEG activity may represent a distinct neurophysiological correlate of ‘cerebellar encephalopathy’. MDPI 2020-04-10 /pmc/articles/PMC7226540/ /pubmed/32290116 http://dx.doi.org/10.3390/brainsci10040227 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Ricci, Lorenzo Motolese, Francesco Tombini, Mario Lanzone, Jacopo Rea, Roberta Di Matteo, Francesco Di Lazzaro, Vincenzo Assenza, Giovanni Metronidazole Encephalopathy EEG Features: A Case Report with Systematic Review of the Literature |
title | Metronidazole Encephalopathy EEG Features: A Case Report with Systematic Review of the Literature |
title_full | Metronidazole Encephalopathy EEG Features: A Case Report with Systematic Review of the Literature |
title_fullStr | Metronidazole Encephalopathy EEG Features: A Case Report with Systematic Review of the Literature |
title_full_unstemmed | Metronidazole Encephalopathy EEG Features: A Case Report with Systematic Review of the Literature |
title_short | Metronidazole Encephalopathy EEG Features: A Case Report with Systematic Review of the Literature |
title_sort | metronidazole encephalopathy eeg features: a case report with systematic review of the literature |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7226540/ https://www.ncbi.nlm.nih.gov/pubmed/32290116 http://dx.doi.org/10.3390/brainsci10040227 |
work_keys_str_mv | AT riccilorenzo metronidazoleencephalopathyeegfeaturesacasereportwithsystematicreviewoftheliterature AT motolesefrancesco metronidazoleencephalopathyeegfeaturesacasereportwithsystematicreviewoftheliterature AT tombinimario metronidazoleencephalopathyeegfeaturesacasereportwithsystematicreviewoftheliterature AT lanzonejacopo metronidazoleencephalopathyeegfeaturesacasereportwithsystematicreviewoftheliterature AT rearoberta metronidazoleencephalopathyeegfeaturesacasereportwithsystematicreviewoftheliterature AT dimatteofrancesco metronidazoleencephalopathyeegfeaturesacasereportwithsystematicreviewoftheliterature AT dilazzarovincenzo metronidazoleencephalopathyeegfeaturesacasereportwithsystematicreviewoftheliterature AT assenzagiovanni metronidazoleencephalopathyeegfeaturesacasereportwithsystematicreviewoftheliterature |