"T2/FLAIR: bilateral, symmetric, hyperintense signal"
"T1 C+ (Gd): non-enhancing"
"DWI: variable, from hyperintense to isointense to normal white matter in lesions of the dentate nucleus, midbrain, medulla, and pons"
"ADC: ADC values of lesions of the dentate nucleus, midbrain, medulla, and pons are similar or higher than those of normal white matter, whilst corpus callosum lesions can show lower values than in normal white matter 3"
"Pathophysiological mechanisms of metronidazole neurotoxicity remain unclear. Metronidazole may inhibit the conversion of thiamine to its biologically active form producing a functional deficiency. Inhibition of the GABA-A receptor may also contribute. Circumstantial evidence also exists for disruption of neuronal oxidative phosphorylation."
"Wernicke encephalopathy"
"Affected patients range widely in age, with the peak incidence occurring in the fifth and sixth decades. Hepatic disease is the most commonly identified risk factor; higher daily doses and longer duration of therapy are also thought to impart an increased risk. Onset is most commonly delayed by weeks to several months, although has been reported to occur within a few days."
"Nearly all cases show lesions in the cerebellum (93-100%) 1,3, particularly of the cerebellar dentate nuclei. There is slightly less frequent involvement of corpus callosum, midbrain, pons, and/or medulla."