TY - JOUR T1 - Acute cerebellar syndrome associated with metronidazole JF - Practical Neurology JO - Pract Neurol SP - 298 LP - 299 DO - 10.1136/practneurol-2014-000974 VL - 15 IS - 4 AU - F Ward AU - P Crowley AU - P E Cotter Y1 - 2015/08/01 UR - http://pn.bmj.com/content/15/4/298.abstract N2 - A 38-year-old man gave a 5-day history of progressively slurred speech, confusion and unsteadiness. He had taken metronidazole for 7 days following a dental procedure. He had a history of Leber's hereditary optic atrophy (LHON), causing reduced visual acuity, but no movement disorder, tremor or cardiac arrhythmia to suggest a ‘LHON plus’ syndrome. On examination, he was encephalopathic with marked dysarthria and ataxia of the trunk, limbs and gait. There was no peripheral neuropathy or palatal myoclonus. Contrast-enhanced CT scan of brain and cerebrospinal fluid (CSF) analysis, including oligoclonal band testing, were normal. T2-weighted MR scan of brain showed bilateral hyperintensity of the dentato-rubro-olivary pathway (Guillain–Mollaret triangle), a functional circuit linking the cerebellar dentate nucleus … ER -