HOME > Weekly Case > Weekly Case
Weekly Case
종결
Case No. 499
2018-11-01~2018-11-30
출제자 : 김슬기
Hit : 539
| Period | 2018-11-01~2018-11-30 |
|---|---|
| Diagnosis | Metronidazole-induced encephalopathy |
| Gender |
|
| Age | 76 |
| Clinical information | 76/F C/C Both lower leg weakness, dysarthria (5 days ago) P/H Colitis treatment (1 week ago) 진단은? |
| Discussion | Metronidazole: used to treat a wide variety of bacterial and protozoal infections can, in exceedingly rare cases, lead to central nervous system toxicity. Produce peripheral neuropathies and cerebellar dysfunction, especially at dosages exceeding 2 g/day for prolonged periods. Neurologic symptom Dysarthria, gait disturbance, weakness of extremity, mental confusion, visual disturbance, tingling sensation MR Findings T2/FLAIR: always bilateral symmetric hyperintense lesions. Location: Cerebellar dentate nuclei, midbrain (tectum, red nucleus, and tegmentum around periaqueductal gray matter), dorsal pons (the vestibular nucleus, a focal tegmental lesion of the superior olivary nucleus, and the abducens nucleus), dorsal medulla, and corpus callosum (splenium). Gd-T1WI: non-enhancing. Treatment: After discontinuation of metronidazole the majority of cases either improve (29%) or have complete resolution of symptoms (65%). |
| Correct answer |
Correct Answer
Semi-Correct Answer |