Chronic Neuropsychological sequelae in a case of severe lithium intoxication.

Abstract

Objective: This case provides data from serial assessments using a comprehensive neuropsychological test battery to assess the effects of severe toxicity on cognitive functioning, the pattern of deficits, and the regions of the brain that appear to be involved.

Background: Lithium carbonate has made a significant contribution to the treatment of bipolar disorder, and considerable investigation has been conducted on both temporary and long-term side effects on the central nervous system. The effects of acute lithium intoxication on the central nervous system have been extensively documented.

Method: We studied a severe case of acute lithium intoxication and associated neuropsychological sequelae. The patient was evaluated twice with a comprehensive battery of neuropsychological tests within 2 years of the lithium intoxication.

Results: Comprehensive neuropsychological evaluations indicated persistent cognitive sequelae, including impaired memory, attention, executive control functions, and visuospatial deficits.

Conclusions: The cognitive sequelae noted in the case of lithium toxicity are consistent with a subcortical dementia and the findings of other authors. Findings should be explored further in more rigorous clinical studies.