Dear Dr Gasmi S

Thank you for this project

 Answer : The cited reference discusses “reversible metronidazole induced CNS disturbances”. These “appear to be associated with specific MRI changes of increased signal intensity of the dentate nuclei bilaterally, most notably seen on FLAIR sequences.” The predominant symptom is ataxia but may include encephalopathy and/or peripheral neuropathy. (Graves TD et al. Reversible metronidazole-induced cerebellar toxicity in a multiple transplant recipient. 2009 J Neurol Sci 285:238-240)

Thank you Mr Soltani N

search for Cytotoxic lesions of the corpus callosum (CLOCCs )

tarkey J, Kobayashi N, Numaguchi Y, Moritani T. Cytotoxic Lesions of the Corpus Callosum That Show Restricted Diffusion: Mechanisms, Causes, and Manifestations. Radiographics. 2017 Mar-Apr;37(2):562-576.

Thank you so much Pr. Nilufer Yesilot

We faced at our weekly case conference in my department a patient that suffered recurrent colitis with diarrhea and was on metronidazole for years and suffered picture resembling subacute combined degeneration ..

Along the literature there are many cases that suffer adverse effects from long durations of treatment with metronidazole some report peripheral manifestations others have central manifestations up to being fatal ..

This is a link for case report that suffered fatal encephalopathy

https://doi.org/10.1016/j.clinthera.2010.01.018

Dear Dr Tamer Roushdy

Thank you very much. Your post is very important. Thank you also for the article link

Best regards!