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MRI of metronidazole induced cerebellar ataxia
  1. Ahsan N V Moosa1,
  2. Dwayne Perkins2
  1. 1Department of Neurology, Cleveland Clinic, Cleveland, Ohio, USA
  2. 2Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, USA
  1. Correspondence to Dr Ahsan N V Moosa, Child Neurology, Department of Neurology, Cleveland Clinic, 9500 Euclid Avenue, Desk S-71, Cleveland OH 44195; naduvia{at}

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Central nervous system neurotoxicity to metronidazole is exceedingly rare. This case illustrates characteristic MRI changes associated with metronidazole-induced cerebellar ataxia.

A 52-year-old man with remote post-traumatic T7 paraplegia presented with acute-onset dysarthria and upper-limb ataxia. He reported to the local emergency department 2 h after coworkers noticed slurred speech. He had a mild inability to button his shirt and drive his car due to clumsiness of hands for the preceding 2 days. Dysarthria rapidly worsened over next 3 days. His past medical history included T7 paraplegia following a motor vehicle accident at 22 years of age and chronic osteomyelitis of right ischium of 2 years. He has been on several courses of antibiotics and surgical debridement …

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  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.