SynthesisJournal of neurology2020
Metronidazole-induced encephalopathy: a systematic review.
Synthesis in Journal of neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 1 of them a synthesis that pooled it.
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Who cites it
63 citing papers in PubMed, 1 synthesis or guideline pooled it, 144 citations in OpenAlex.
- Posterior reversible encephalopathy syndrome associated with antibiotic therapy: a case report and systematic review.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024Pooled it
- Agent-Specific Clinical Profiles of Antibiotic-Associated Encephalopathy: A Dual-Database Pharmacovigilance Study Using JADER and FAERS.Antibiotics (Basel, Switzerland) · 2026Article
- Metronidazole-associated mood changes: A case report.Exploratory research in clinical and social pharmacy · 2026Article
- Safety Monitoring of High-Risk Antibiotics Using Artificial Intelligence: A Narrative Review with Focus on Real-World Evidence.Life (Basel, Switzerland) · 2026Review
- Article
- Metronidazole-Induced Neurotoxicity: A Case Report.Cureus · 2026Article
- Article
- Reversible Metronidazole-Induced Encephalopathy With Typical MRI Features Following a Low Cumulative Dose: Case Report.Clinical medicine insights. Case reports · 2026Article
- Article
- From Treatment to Toxicity: Metronidazole-Induced Encephalopathy in a 79-Year-Old Woman.Clinical case reports · 2025Article
- Combination of mitomycin C and low-dose metronidazole synergistically againstAntimicrobial agents and chemotherapy · 2025Article
- Ornidazole-induced involuntary tremor in a Chinese woman: a rare case report and literature review.BMC neurology · 2025Review
- Metronidazole induces genotoxicity, hepato- and nephrotoxicity by triggering DNA fragmentation in Swiss albino mice (Balb/c).Scientific reports · 2025Article
- Reversible Neurological Toxicity Owing to Metronidazole Use.The American journal of tropical medicine and hygiene · 2025Article
- Metronidazole-induced cerebellar dysfunction: An underdiagnosed identity.Journal of family medicine and primary care · 2025Article
- Clinical characterization, natural history, and neuroimaging of cerebellar ataxia after abdominal surgery.Arquivos de neuro-psiquiatria · 2025Article
- Relationship between antibiotic use and short-term risk of mortality in patients with sepsis-associated encephalopathy: a study based on the medical information mart for intensive care database.BMC infectious diseases · 2025Observational
- Cost-Effective Nanosensor Solutions for Ultra-Sensitive Detection of Metronidazole.Analytical science advances · 2025Review
- Nitazoxanide Analogs: Synthesis, In Vitro Giardicidal Activity, and Effects onInternational journal of molecular sciences · 2025Article
- A rare clinical presentation of metronidazole-induced dysarthria: A Case report with literature review.Radiology case reports · 2025Article
3 more citing papers are in PubMed but not listed here.
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsMetronidazole, a commonly used antibiotic drug, can cause adverse effects in the central nervous system termed metronidazole-induced encephalopathy, leading to diagnostic challenges. The condition is rare and a detailed description of its phenotype is lacking. In this systematic review we investigated the clinical features of metronidazole-induced encephalopathy to promote recognition and elaborate the description.
methodsWe performed a systematic literature search using PubMed.gov and hand searched the reference lists of included articles and other publications of interest. We included case series and single reports describing individual patients developing symptoms from the central nervous system in relation to metronidazole treatment. Data were extracted and analyzed descriptively.
resultsWe identified 779 publications of which 112 papers comprising 136 patients were included. Typical findings were dysarthria, gait instability, limb dyscoordination and altered mental status. Frequently, patients concomitantly presented with metronidazole-induced polyneuropathy. Liver disease was the most common pre-existing condition. MRI showed a characteristic pattern of reversible symmetrical hyperintense lesions on T2/FLAIR of the dentate nuclei in 90% of patients. Most patients improved significantly after discontinuation of metronidazole. Poor outcome was associated with severe comorbidity.
conclusionMetronidazole-induced encephalopathy should be considered in patients presenting with neurological symptoms in relation to newly initiated or prolonged metronidazole treatment. MRI changes are highly characteristic and specific. Patients with liver disease are at increased risk. Prognosis is good if recognized early.
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