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Persistent cognitive deficits associated with lithium intoxication: a neuropsychological case description
Lisa Bartha1, Josef Marksteiner, Gerhard Bauer
1University Clinic of Neurology, Innsbruck, Austria.
Summary
Acute lithium intoxication can cause significant cognitive deficits, including memory and executive function impairments. Some deficits may persist even after lithium levels normalize, suggesting potential long-term neurological effects.
Area of Science:
- Neuroscience
- Clinical Neurology
Background:
- Lithium is a mood stabilizer commonly used to treat bipolar disorder.
- Acute lithium intoxication can lead to various neurological and cognitive symptoms.
Observation:
- A 51-year-old patient presented with acute lithium intoxication and significant cognitive deficits.
- Symptoms included psychomotor slowing, dysarthria, mood changes, ideomotor apraxia, visuospatial deficits, memory, and executive function impairment.
- Electroencephalogram showed diffuse slowing; MRI was normal.
Findings:
- Despite prompt lithium withdrawal, cognitive deficits in praxis and visuoperception persisted at 4 and 14 weeks.
- Memory and executive functions showed substantial recovery.
- Lithium intoxication may cause multifocal impairment of subcortical and cortical neural mechanisms.
Implications:
- Lithium intoxication can result in variable and potentially persistent cognitive impairments.
- This case suggests a combined, multifocal impact on neural mechanisms, differing from previous reports.
- Highlights the importance of monitoring lithium levels and potential long-term neurological sequelae.