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Journal of Pediatric Neurology 2023; 21(05): 391-394
DOI: 10.1055/s-0042-1757623
Case Report

A Rare Case of Encephalopathy in Children—Known but Unknown

Mukesh Kumar Jain 
1   Department of Pediatrics, Kalinga Institute of Medical Sciences, Kalinga Institute of Industrial Technology, Bhubaneswar, Odisha, India
,
Chinmaya Kumar Behera 
1   Department of Pediatrics, Kalinga Institute of Medical Sciences, Kalinga Institute of Industrial Technology, Bhubaneswar, Odisha, India
,
Sangram Panda 
2   Department of Radiodiagnosis, Kalinga Institute of Medical Sciences, Kalinga Institute of Industrial Technology, Bhubaneswar, Odisha, India
,
Sibabratta Patnaik 
1   Department of Pediatrics, Kalinga Institute of Medical Sciences, Kalinga Institute of Industrial Technology, Bhubaneswar, Odisha, India
,
Bandya Sahoo 
1   Department of Pediatrics, Kalinga Institute of Medical Sciences, Kalinga Institute of Industrial Technology, Bhubaneswar, Odisha, India
,
Reshmi Mishra 
1   Department of Pediatrics, Kalinga Institute of Medical Sciences, Kalinga Institute of Industrial Technology, Bhubaneswar, Odisha, India
,
Jyoti Ranjan Behera 
1   Department of Pediatrics, Kalinga Institute of Medical Sciences, Kalinga Institute of Industrial Technology, Bhubaneswar, Odisha, India
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Abstract

Metronidazole-induced encephalopathy is a rare cause of toxic encephalopathy in children. Although many cases have been reported in adults, it is rarely reported in the pediatric population. Here, we report a case of an 11-year-old boy who presented with acute-onset encephalopathy with slurring of speech after receiving metronidazole for treatment of acute gastroenteritis. Neuroimaging is the cornerstone in the diagnosis of this entity with typical involvement of cerebellum, brain stem, and splenium of the corpus callosum. In our case, magnetic resonance imaging of the brain revealed hyperintensity of the splenium of the corpus callosum on the fluid-attenuated inversion recovery sequence along with diffusion restriction in the diffusion-weighted imaging and apparent diffusion coefficient images. Rapid complete neurological and radiological recovery with supportive treatment is key in making the diagnosis. Although a safer and commonly used drug, new-onset encephalopathy after the use of metronidazole must be considered.

Keywords

metronidazole - encephalopathy - children - corpus callosum

Ethical Approval

Waved off as a case report, as an institutional policy.




Publication History

Received: 01 June 2022

Accepted: 31 August 2022

Article published online:
24 November 2022

© 2022. Thieme. All rights reserved.

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