Choreoathetosis as Toxic Effect of Lithium Treatment

Abstract

Two cases of lithium neurotoxic effects are reported. Both cases are expressed by choreoathetotic movements and in both of them intoxication was caused by combined drug therapy. In our opinion caution is advised when lithium is administered in combination with drugs, especially in elderly patients.

A case of lithium-induced parkinsonism presenting with typical motor symptoms of Parkinson's disease in a bipolar patient

“…The pathophysiological mechanism behind LIP is unclear (Walevski and Radwan, 1986). One hypothesis suggests that lithium reduces the number of dopamine receptors in the striatum or in the limbic system (Engel, 1980).…”

Severe Generalized Polyneuropathy in Lithium Intoxication

“…Acute lithium intoxication can produce muscular twitches, tremor, choreoathetosis, consciousness distur bance, convulsions, and coma [9,10,12]. After recovery from unconsciousness, neurological sequelae such as cer ebellar ataxia, dysarthria, nystagmus, tremor, hypokine sia, rigidity, parkinsonian features, hypertonia, spastici ty, and dementia may become increasingly apparent [2,9], Generalized polyneuropathy in lithium intoxication is rarely reported [1,8,11], although evidence of periph eral nerve damage can occasionally be found in clinical descriptions of case reports on lithium intoxication [4][5][6], We report a case of a severe generalized polyneuropa thy due to lithium intoxication with an unusual evolu tion of clinical manifestations.…”

Choreoathetosis related to lithium intoxication

“…, 1996). In addition, the patient was also taking a thiazide diuretic – a drug also known to increase serum lithium concentration (Walevski and Radwan, 1986, Timmer and Sands, 1999). As lithium is excreted almost entirely by the kidneys (Okusa and Crystal, 1994) even a mildly impaired kidney function as evidenced by the increased creatinine level might contribute to an increase n the serum lithium concentration.…”