Reversible oro-lingual dyskinesia related to lithium intoxication

To report the first case of Taiwanese with lithium intoxication presenting as oro-lingual dyskinesia.

A 68-year-old man had bipolar disorder with chronic lithium treatment. He had acute conscious disturbance, atrial flutter, myoclunus of limbs, and oro-lingual dyskinesia. Biochemistry study revealed elevated blood urea nitrogen, creatinine, and lithium level (3.43 Eq/L). The lithium is discontinued and he received conservational treatment. Along with reduction of serum lithium level, his involuntary movement subsided following by clear consciousness. He had no residual neurological deficit in 3 years of follow up.

Oro-lingual dyskinesia is a rare presentation of lithium intoxication. This case reminds us such diagnostic possibilities especially in elder patients who receive a chronic lithium therapy.