Permanent Cerebellar Degeneration After Acute Hyperthermia with Non-toxic Lithium Levels: a Case Report and Review of Literature

Abstract

This was a study of a 33-year-old man with bipolar disorder treated with lithium who developed cerebellar atrophy after an event of extreme hyperthermia. Unlike previously reported cases of acute cerebellar atrophy after heat stroke, neuroleptic syndrome or lithium toxicity, this case was characterized by a chronic cerebellar atrophy that developed after sepsis-induced hyperthermia in the setting of non-toxic lithium levels. Unique to this case also was the early finding of cerebellar atrophy on MRI 2 weeks after the episode of hyperthermia, long-term neurotoxicity after the novo lithium therapy, and longest follow-up case of chronic cerebellar syndrome after hyperthermia with non-toxic lithium levels.

Lithium in the Normal Therapeutic Range: A Potential Sneaky Danger for the Brain. A Case of Slow Tricking Neurotoxicity and a Brief Overview of Literature

“…Early in the treatment, lithium may cause tremor and this kind of acute intoxication may cause renal failure, thyroid dysfunction, cardiac arrhythmias and, as far as neurotoxicity is concerned, tremor, drowsiness, nystagmus, confusion, ataxia, extrapyramidal symptoms, stuttering [1,2] and even chronic cerebellar atrophy [3]. In the most severe forms of intoxication, seizure, coma and death can occur [4].…”