Tardive Tourette syndrome is characterized by the occurrence of multiple motor and vocal tics in patients on long-term neuroleptic, antiepileptic medication or stimulants, and was first reported by Golden in 1974 and was given its name in 1980 by Steven Stahl who linked it to tardive dyskinesia. The Medline was searched with the combination of the words 'tardive' or 'induced' or 'late' and 'Tourette' or 'Tourettism' and 375 papers were indentified; 42 of them were judged to be relevant. Forty-one cases were identified, caused by antipsychotics, antiepileptics, stimulants and other medication. A number of treatment options are reported in the literature but no systematic study of the syndrome has been done yet.
AbstractWe report a case of a 63-year-old male who has been admitted to the Emergency department with nonspecific symptoms. Lithium toxicity was not at first recognized. When we obtained sufficient information about previous medication and medical history, we measured lithium levels found to be 1.46 mmol/L. Although the value of lithium was mildly elevated, nephrotoxicity was produced leading to severe renal insufficiency and neurological symptoms. Hemodialysis was started, and we succeed to treat the patient without squeals. This case illustrates some of the factors that lead to lithium toxicity as well as the need to consider lithium toxicity to the differential diagnosis of a patient presenting with renal insufficiency with or without change in mental status and neurologic symptom.
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