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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2018; 28(04): 480
DOI: 10.4103/ijri.IJRI_499_17
Letters to the Editor

Drug-induced changes in dentate nuclei of cerebellum

Yashant Aswani
Department of Radiology, PMCH, Udaipur
,
Nishant Aswani
Department of Neurology, GB Pant Hospital, New Delhi, India
,
Rohit Sharma
Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.
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Sir,

We read with great interest the article titled “Sequential MR imaging (with diffusion-weighted imaging) changes in metronidazole-induced encephalopathy” by Singh et al. in the April–June 2017 issue of the Indian Journal of Radiology and Imaging.[1] The article is highly informative and describes signal changes in splenium and dentate nuclei following metronidazole ingestion. In this article, we describe a few drugs that cause similar signal changes in the cerebellar dentate nuclei [Table 1]:

Table 1

Drugs that cause signal change in dentate nuclei

Drug

Use

Area of brain affected

T2/FLAIR hyperintense

Resolution upon discontinuation of drug

A[1],[2] Metronidazole

Antibiotic, amebicide, antiprotozoal agent

Dentate nuclei, midbrain, inferior colliculus, dorsal pons and medulla, inferior olivary nucleus, splenium

Yes, shows diffusion restriction

Yes

B[2] Monohalothane

Fumigative pesticide

Dentate nuclei, periaqueductal region of midbrain, inferior colliculus, splenium, globus pallidus, thalamus, lower cranial nerve nuclei

Yes, no diffusion restriction

Yes

C[3] Isoniazid

First line antitubercular therapy

Dentate nuclei

Yes, may show diffusion restriction

Yes

D[2],[4] Cycloserine

Second line antitubercular therapy

Dentate nuclei

Yes, shows diffusion restriction

Yes

Thus, we see that the dentate nuclei can be affected by many drugs with nonspecific magnetic resonance imaging findings. Hence, integration of clinical data is crucial for definitive diagnosis.[4]


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Conflict of Interest

There are no conflicts of interest.

  • References

  • 1 Singh R, Kaur R, Pokhariyal P, Aggarwal R. Sequential MR imaging (with diffusion-weighted imaging) changes in metronidazole-induced encephalopathy. Indian J Radiol Imaging 2017; 27: 129-32
    Thieme ConnectPubMedSearch in Google Scholar
  • 2 Khadilkar S, Jaggi S, Patel B, Yadav R, Hanagandi P, Faria do Amaral LL. A practical approach to diseases affecting dentate nuclei. Clin Radiol 2016; 71: 107-19
    CrossrefPubMedSearch in Google Scholar
  • 3 Peter P, John M. Isoniazid-induced cerebellitis: A disguised presentation. Singapore Med J 2014; 55: e17-9
    CrossrefPubMedSearch in Google Scholar
  • 4 Kim S, Kang M, Cho JH, Choi S. Reversible magnetic resonance imaging findings in cycloserine-induced encephalopathy: A case report. Neurol Asia 2014; 19: 417-9
    Search in Google Scholar


Publication History

Article published online:
26 July 2021

© 2018. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Singh R, Kaur R, Pokhariyal P, Aggarwal R. Sequential MR imaging (with diffusion-weighted imaging) changes in metronidazole-induced encephalopathy. Indian J Radiol Imaging 2017; 27: 129-32
    Thieme ConnectPubMedSearch in Google Scholar
  • 2 Khadilkar S, Jaggi S, Patel B, Yadav R, Hanagandi P, Faria do Amaral LL. A practical approach to diseases affecting dentate nuclei. Clin Radiol 2016; 71: 107-19
    CrossrefPubMedSearch in Google Scholar
  • 3 Peter P, John M. Isoniazid-induced cerebellitis: A disguised presentation. Singapore Med J 2014; 55: e17-9
    CrossrefPubMedSearch in Google Scholar
  • 4 Kim S, Kang M, Cho JH, Choi S. Reversible magnetic resonance imaging findings in cycloserine-induced encephalopathy: A case report. Neurol Asia 2014; 19: 417-9
    Search in Google Scholar

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