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Case No. 293
2013-02-04~2013-02-28
출제자 : 최진욱
Hit : 451
| Period | 2013-02-04~2013-02-28 |
|---|---|
| Diagnosis | Metronidazole toxicity |
| Clinical information | 41/F Past history : HTN, DM으로 medication 중이며 ESRD s/p KT로 신장내과 f/u 중, LLL invasive pulmonary aspergillosis UTI sepsis, pseudomembranous colitis 치료 받은 자 Sudden onset의 dysarthria, lower extremity weakness 발생 MRI 시행. 진단은? |
| Discussion | Metronidazole toxicity Metronidazole can produce neurologic symptoms at doses exceeding 2 g/d. The symptoms commonly described are dysarthria, gait disturbance, weakness of the extremities, and mental confusion. Imaging findings - MRI Cerebellar dentate nuclei involvement – M/C & Midbrain (tectum, red nucleus, tegmentum around periaqueductal gray matter), dorsal pons. Dorsal medulla, corpus callosum (splenium) less often affected. Often bilateral & symmetric. Lesion shows increased signal intensity on T2-weighted images. No contrast enhancement Reversible after discontinuation of the drug. |
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