EC Pharmacology And Toxicology

A 57 year-old male patient presented to the ED with a chief complaint of paralysis and sensory deficits in his lower extremities. Preliminary diagnosis of transverse myelitis was soon ruled out. Differential diagnoses of Guillain-Barré syndrome, Lyme disease and West Nile virus were additionally ruled out. Upon closer analysis of the patient’s medication history and bloodwork analysis, vi- tamin B12 deficiency-induced myelitis and metronidazole-induced neuropathy were suspected. Upon drug cessation and cobalamin supplementation, the patient rapidly regained his ability to walk within two weeks. Due to this patient’s co-presentation of B12 defi- ciency with chronic metronidazole use and due to his rapid recovery time, this is a non-classical case that warrants further analysis.

Keywords: Metronidazole; B12; Cobalamin; Acute Myelitis; Transverse Myelitis; Paraplegia

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