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Intermittent Transient Motor Aphasia Associated with Acute Lithium Toxicity: A Case Report and Brief Review.

Subramoniam Madhusoodanan¹, Varudhini Reddy², Sonya Mohan³

¹Department of Psychiatry, St. John's Episcopal Hospital, 327 Beach 19th Street, Far Rockaway, NY 11691, USA and Clinical Professor of Psychiatry, S.U.N.Y. Health Science Center at Brooklyn, NY. United States.

Current Drug Safety

|June 3, 2017

Summary

Lithium toxicity can cause temporary aphasia, a speech disorder. This case highlights the importance of monitoring lithium levels and fluid balance in patients to prevent this rare neurological side effect.

Keywords:

Acute toxicity aphasia intermittent lithium motor transient

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Area of Science:

Neuroscience
Pharmacology
Psychiatry

Background:

Lithium is a common treatment for bipolar disorder and other psychiatric conditions.
Neurological deficits are known side effects of lithium, but aphasia is rarely reported.
This study focuses on a case of transient aphasia linked to lithium toxicity.

Observation:

A 70-year-old woman with schizoaffective disorder and dementia developed intermittent aphasia.
The aphasia occurred when her lithium levels reached 1.5 mEq/L, indicating toxicity.
Other causes for aphasia were ruled out through CT scans and neurological consultations.

Findings:

Discontinuation of lithium and rehydration with intravenous fluids led to complete resolution of aphasia within 2-3 days.
The patient's high sodium level (148 mmol/L) may have contributed to lithium toxicity.
The Naranjo scale indicated a probable adverse drug reaction to lithium.

Implications:

Clinicians should consider aphasia as a potential, albeit rare, side effect of lithium toxicity.
Close monitoring of lithium levels, fluid intake, and electrolytes is crucial, especially in patients at risk of dehydration.
Early recognition and management can prevent prolonged neurological deficits.