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[There's not only Alzheimer's disease].
M Nardi1, M Anwander, B Rüegger-Frey
1Klinik für Akutgeriatrie, Stadtspital Waid.
Praxis
|July 20, 2012
Summary
Lithium intoxication can cause severe neurological symptoms even with normal blood levels. Reducing the lithium dose can lead to significant recovery of neurological function.
Area of Science:
- Neurology
- Clinical Toxicology
Background:
- Lithium is a common mood stabilizer used in treating bipolar disorder.
- Lithium toxicity can present with a wide range of neurological symptoms, often correlating with serum levels.
- Normal serum lithium levels do not always exclude the possibility of lithium toxicity, especially in cases of chronic or subacute intoxication.
Observation:
- A 59-year-old male presented with rapidly progressive cognitive decline, neurological symptoms, and recurrent falls.
- Differential diagnosis included various neurological conditions and lithium intoxication.
- Initial lithium blood levels were within the therapeutic range, complicating the diagnosis of lithium toxicity.
Findings:
- Despite normal lithium blood levels, the patient's presentation was highly suggestive of lithium intoxication.
- A reduction in the lithium dosage led to a significant regression of neurological symptoms.
- Cognitive impairments showed partial but not complete resolution after dose adjustment.
Implications:
- This case highlights the importance of considering lithium toxicity even with normal serum lithium levels in patients with unexplained neurological decline.
- Clinicians should maintain a high index of suspicion for lithium toxicity in patients on lithium therapy presenting with neurological symptoms.
- Careful dose adjustment and monitoring are crucial for managing lithium therapy and preventing toxicity.
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