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Choreoathetosis related to lithium intoxication.
B Stemper1, N Thürauf, B Neundörfer
1Stroke Unit, Department of Neurology, University of Erlangen-Nürnberg, Erlangen, Germany. brigitte.stemper@neuro.med.uni-erlangen.de
European Journal of Neurology
|December 4, 2003
Summary
A 76-year-old woman presented with severe gait ataxia and dysarthric speech. Lithium toxicity was diagnosed due to new-onset choreoathetotic movements, leading to prompt treatment.
Area of Science:
- Neurology
- Toxicology
Background:
- A 76-year-old female patient experienced acute neurological deterioration.
- Initial symptoms included severe gait ataxia and dysarthric speech, worsening over 24 hours.
Observation:
- The patient's symptoms were initially suspected as repeated transitory ischemic attacks (TIAs).
- New-onset spontaneous choreoathetotic movements of the hands and arms were observed.
- Symptom exacerbation occurred one hour post-admission.
Findings:
- A history of lithium therapy was noted.
- The combination of neurological symptoms and lithium use led to the diagnosis of lithium toxicity.
- Prompt diagnosis and treatment were initiated.
Implications:
- This case highlights the importance of considering lithium toxicity in patients presenting with acute neurological changes, especially movement disorders.
- Early recognition and management of lithium toxicity are crucial for preventing severe neurological sequelae.
- Clinicians should maintain a high index of suspicion for drug-induced movement disorders in elderly patients with a history of lithium use.