Choreoathetosis: a sign of lithium toxicity

Two patients who developed choreoathetosis in the course of lithium treatment are described, and other cases of choreoathetosis in lithium-treated patients are reviewed. Choreoathetosis is suggested to be a sign of lithium toxicity, almost always accompanied by other signs of neurotoxicity, such as delirium and cerebellar dysfunction. Of the reported cases, 44% developed permanent movement disorders, and 63% of the patients with permanent deficits were taking both lithium and neuroleptic. When choreoathetosis was not permanent, the average duration was seven days after discontinuation of lithium (range, 1 to 90 days).