Two Cases of Metronidazole-induced Encephalopathy During the Treatment of Refractory Leg Ulcers

Abstract

 Metronidazole-induced encephalopathy (MIE) is a relatively rare disorder that causes central nervous system dysfunction including cerebellar ataxia and external ophthalmoplegia. We experienced two cases of MIE during the treatment of refractory leg ulcers. The patients' clinical courses, specific magnetic resonance imaging findings, and significant improvement after cessation of metronidazole led to a definitive diagnosis of MIE. There have been a few reports of irreversible loss of consciousness; however, in both the present cases, the symptoms were reversible and improved within a week. Herein, we review the literature relating to MIE and aim to promote the recognition of MIE in plastic and reconstructive surgery.