{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:28:53Z","timestamp":1762867733060,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,2,13]]},"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:p>Neurotoxicity is a rare but significant side effect of metronidazole. We present, here, a case of a 34-year-old man, presenting with garbled speech and word finding difficulty. He was taking metronidazole for the last 3\u2009months for stage 4 decubitus ulcers. MRI of the brain showed abnormal signal intensities in the splenium of the corpus callosum and dentate nuclei of the cerebellum. The diagnosis of metronidazole-induced neurotoxicity was made based on MRI findings. The antibiotic was stopped leading to resolution of abnormal MRI findings. We advocate that metronidazole can be associated with severe neurotoxicity, but its prompt cessation leads to better outcome and prognosis.<\/jats:p>","DOI":"10.1136\/bcr-2018-227804","type":"journal-article","created":{"date-parts":[[2019,3,2]],"date-time":"2019-03-02T05:35:12Z","timestamp":1551504912000},"page":"e227804","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Garbled speech: a rare presentation of metronidazole-induced neurotoxicity"],"prefix":"10.1136","volume":"12","author":[{"given":"Muhammad Arslan","family":"Cheema","sequence":"first","affiliation":[{"name":"Internal Medicine, Abington Hospital - Jefferson Health, Abington, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"FNU","family":"Salman","sequence":"additional","affiliation":[{"name":"Internal Medicine, Khyber Teaching Hospital, Peshawar, Khyber Pakhtunkhwa, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4850-0309","authenticated-orcid":false,"given":"Waqas","family":"Ullah","sequence":"additional","affiliation":[{"name":"Internal Medicine, Abington Hospital - Jefferson Health, Abington, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Abdullah","family":"Zain","sequence":"additional","affiliation":[{"name":"Internal Medicine, Sheikh Zayed Medical College, Rahim Yar Khan, Punjab, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,3,1]]},"reference":[{"key":"2025082622413919000_12.3.e227804.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200201033460117"},{"key":"2025082622413919000_12.3.e227804.2","first-page":"120","article-title":"Metronidazole-induced encephalopathy: an uncommon scenario","volume":"127","author":"Chakrabarti","year":"2014","journal-title":"N Z Med J"},{"key":"2025082622413919000_12.3.e227804.3","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.45.3.588"},{"key":"2025082622413919000_12.3.e227804.4","doi-asserted-by":"crossref","first-page":"569","DOI":"10.4103\/0972-2327.120472","article-title":"Clinical and imaging perspective and unanswered questions in a case of metronidazole induced encephalopathy","volume":"16","author":"Iqbal","year":"2013","journal-title":"Ann Indian Acad Neurol"},{"key":"2025082622413919000_12.3.e227804.5","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/19.2.346"},{"key":"2025082622413919000_12.3.e227804.6","doi-asserted-by":"publisher","DOI":"10.1177\/1051228404267597"},{"key":"2025082622413919000_12.3.e227804.7","doi-asserted-by":"crossref","first-page":"743","DOI":"10.4103\/0028-3886.86552","article-title":"Clinical, neuroimaging and pathological features of 5-nitroimidazole-induced encephalo-neuropathy in two patients: Insights into possible pathogenesis","volume":"59","author":"Chacko","year":"2011","journal-title":"Neurol India"},{"key":"2025082622413919000_12.3.e227804.8","doi-asserted-by":"crossref","DOI":"10.1212\/01.wnl.0000242579.37851.26","article-title":"Acute reversible cerebellar lesions associated with metronidazole therapy","volume":"68","author":"Bonkowsky","year":"2007","journal-title":"Neurology"},{"key":"2025082622413919000_12.3.e227804.9","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.07.3959"},{"key":"2025082622413919000_12.3.e227804.10","doi-asserted-by":"publisher","DOI":"10.4103\/0971-3026.69355"},{"key":"2025082622413919000_12.3.e227804.11","first-page":"TD06","article-title":"A case report of metronidazole induced neurotoxicity in liver abscess patient and the usefulness of MRI for its diagnosis","volume":"10","author":"Chandak","year":"2016","journal-title":"J Clin Diagn Res"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-227804","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T05:41:50Z","timestamp":1756273310000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-227804"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3]]},"references-count":11,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2019,3,1]]},"published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1136\/bcr-2018-227804"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-227804","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2019,3]]}}}