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Oculogyric Crisis Due to Metronidazole Toxic Encephalopathy

메트로니다졸 독성 뇌병증으로 인한 안구운동발작

  • Lee, Sang-Woo (Department of Neurology, Soonchunhyang University Bucheon Hospital) ;
  • Kim, Hyeongseok (Department of Neurology, Soonchunhyang University Bucheon Hospital) ;
  • Heo, Deokhyun (Department of Neurology, Soonchunhyang University Bucheon Hospital) ;
  • Park, Jeong-Ho (Department of Neurology, Soonchunhyang University Bucheon Hospital)
  • 이상우 (순천향대학교 부천병원 신경과) ;
  • 김형석 (순천향대학교 부천병원 신경과) ;
  • 허덕현 (순천향대학교 부천병원 신경과) ;
  • 박정호 (순천향대학교 부천병원 신경과)
  • Received : 2018.04.30
  • Accepted : 2018.06.19
  • Published : 2018.11.30

Abstract

Oculogyric crisis is an acute dystonia involving ocular muscles characterized by sustained conjugate upward or lateral deviation of the eyes. Metronidazole is a commonly used antimicrobial agent in treatment of anaerobic infections. However, its long-term use can cause toxic encephalopathy particularly in patients with hepatic dysfunction. Here, we describe a case of oculogyric crisis as a presenting manifestation of metronidazole-induced encephalopathy.

References

  1. Barow E, Schneider SA, Bhatia KP, Ganos C. Oculogyric crises: etiology, pathophysiology andtherapeutic approaches. Parkinsonism Relat Disord 2017;36:3-9. https://doi.org/10.1016/j.parkreldis.2016.11.012
  2. Heimburger RF. Positional oculogyric crises. Case report. J Neurosurg 1988;69:951-953. https://doi.org/10.3171/jns.1988.69.6.0951
  3. Veerapandiyan A, Gallentine WB, Winchester SA, Baker J, Kansagra SM, Mikati MA. Oculogyric crises secondary to lamotrigine overdosage. Epilepsia 2011;52:e4-e6. https://doi.org/10.1111/j.1528-1167.2010.02967.x
  4. Sandyk R. Oculogyric crisis induced by lithium carbonate. Eur Neurol 1984;23:92-94. https://doi.org/10.1159/000115684
  5. Reeves AL, So EL, Sharbrough FW, Krahn LE. Movement disorders associated with the use of gabapentin. Epilepsia 1996;37:988-990. https://doi.org/10.1111/j.1528-1157.1996.tb00537.x
  6. Roy U, Panwar A, Pandit A, Das SK, Joshi B. Clinical and neuroradiological spectrum of metronidazole induced encephalopathy: our experience and the review of literature. J Clin Diagn Res 2016;10:OE01-OE09.
  7. Kim E, Na DG, Kim EY, Kim JH, Son KR, Chang KH. MR imaging of metronidazole-induced encephalopathy: lesion distribution and diffusion-weighted imaging findings. AJNR Am J Neuroradiol 2007;28:1652-1658. https://doi.org/10.3174/ajnr.A0655
  8. Neychev VK, Fan X, Mitev V, Hess EJ, Jinnah HA. The basal ganglia and cerebellum interact in the expression of dystonic movement. Brain 2008;131:2499-2509. https://doi.org/10.1093/brain/awn168