Encephalopathy secondary to metronidazole

Here is a case presentation and brief discussion in NEJM (free full text). From the paper:

Encephalopathy associated with metronidazole use is an uncommon side effect of the medication. It typically manifests as dysarthria and gait instability. Risk factors include liver dysfunction and a prolonged course of metronidazole (typical cumulative dose, greater than 20 g). MRI of the brain is usually diagnostic and typically reveals a symmetric, enhanced FLAIR signal in the dentate nuclei of the cerebellum.