Permanent neurological sequelae despite haemodialysis for lithium intoxication

THREE PATIENTS WITH LITHIUM TOXICITY ARE REPORTED, TWO OF WHOM WERE EXPOSED TO TOXIC LITHIUM LEVELS FOR A PROLONGED PERIOD: both survived with permanent damage to basal ganglia and cerebellar connexions despite effective lowering of lithium levels by haemodialysis. Data obtained during dialysis treatment show prolonged haemodialysis to be the treatment of choice. If facilities for haemodialysis are not available or the patient presents with toxic lithium levels and minimal symptoms peritoneal dialysis will effectively lower serum lithium levels, but more slowly than haemodialysis.