Metronidazole neuropathy.

Abstract

Metronidazole neuropathyMetronidazole is one of the 5-nitroimidazole group of compounds, several of which have found a wide range of applications in thera- peutics.Metronidazole is well established as a protozoacide in trichomoniasis,' giardiasis, and amoebiasis; as a bactericidal agent in anaerobic infections2-15; and as a potentiating agent in radiotherapy.6-7Its use has been suggested for various other conditions including alcoholism,' Crohn's disease,9 endocrine exophthalmos,"' rheumatoid arthritis," rosacea," and acne.'3Tanga et all4 have evaluated metronidazole as an anti-inflammatory agent.Despite the fears prompted by animal experiments that metronidazole might be mutagenic or teratogenic,' 15-1 it has proved remarkably safe in clinical practice.' 17Nevertheless, six cases of peripheral neuropathy with metronidazole have been reported,2 9 18 19 and we describe here a further patient with peripheral neuropathy due to metronidazole.We also describe animal studies performed to investigate the mechanism of neurotoxicity. Case reportThis 33-year-old man had a 17-year history of histologically confirmed Crohn's disease.He had undergone three bowel resections (right hemico- lectomy, resection of the ileocolonic anastomosis and part of the ileum with