Reversible Signal Abnormalities in Bilateral Dentate Nuclei Secondary to Isoniazid Neurotoxicity

An 11-year-old Colombian female on isoniazid for recently diagnosed latent tuberculosis presented to the emergency department after a first-time, generalized tonic-clonic seizure. She exhibited mild bilateral hypometria on finger-to-nose testing, lower limb ataxia on heel-to-shin testing, and dysmetria on rhythmic finger tapping. MRI brain revealed symmetric T2/FLAIR hyper intensities with diffusion restriction and apparent diffusion coefficient correlate in bilateral dentate nuclei (Figure 1A, Figure 1B, Figure 1C).