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...

Descripción completa

Detalles Bibliográficos
Autores principales: Ricci, Lorenzo, Motolese, Francesco, Tombini, Mario, Lanzone, Jacopo, Rea, Roberta, Di Matteo, Francesco, Di Lazzaro, Vincenzo, Assenza, Giovanni
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