Síndrome de Neurotoxicidade Irreversível Causada por Lítio

Silva, Ana Luísa; Ourique, Carolina; Martins, Filipe Pereira; Friões, Fernando

doi:10.20344/amp.7907

Cited by 4 publications

(1 citation statement)

References 3 publications

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“…To the best of our knowledge, this is the first case of a successful treatment approach to SILENT, a condition previously considered irreversible with no fruitful therapeutical trials described in the literature. 7 This case should raise awareness to the potential clinical benefit of levodopa in patients with SILENT presenting with frontal lobe dysfunction.…”

Section: Discussionmentioning

confidence: 93%

Levodopa for Syndrome of Irreversible Lithium-Effectuated Neurotoxicity: a SILENT Recovery

Laranjinha¹

2021

Sinapse

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Section: Discussionmentioning

confidence: 93%

Levodopa for Syndrome of Irreversible Lithium-Effectuated Neurotoxicity: a SILENT Recovery

Laranjinha¹

2021

Sinapse

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A reappraisal of the role of fever in the occurrence of neurological sequelae following lithium intoxication: a systematic review

Verdoux

Debruyne

Queuille

et al. 2021

Expert Opinion on Drug Safety

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Subcortical Structure Disruption in Diffusion Tensor Tractography of the Patient With the Syndrome of Irreversible Lithium-Effectuated Neurotoxicity Combined With Neuroleptic Malignant Syndrome: A Case Report

Rhee

Kim

2021

Clin Neuropharm

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Background Lithium can cause not only acute neurotoxicity but also chronic and persistent neurotoxicity known as syndrome of irreversible lithium-effectuated neurotoxicity (SILENT). The combined use of lithium and antipsychotics increases the possibility of SILENT. Neuroleptic malignant syndrome (NMS) is a reversible, idiosyncratic, and potentially life-threatening reaction, which is usually caused by antipsychotics and other agents, such as mood stabilizers (eg, lithium and metoclopramide). Neuroleptic malignant syndrome is characterized by hyperpyrexia, muscle rigidity, and altered mental status. We describe a case of SILENT combined with NMS in this case report. Case Report A 46-year-old man who had been treated with lithium for bipolar II disorder since 2008 was prescribed lorazepam, lithium, and aripiprazole at his last outpatient visit. The patient experienced financial difficulties (bankruptcy) and suffered severe emotional stress. Subsequently, he overused lorazepam, lithium, and aripiprazole. Two days after the overdose, he experienced a high fever, confused mental status, and rhabdomyolysis and was diagnosed with NMS. However, even after resolution of NMS-related symptoms, quadriplegia, visual field defects, ataxia, and severe dysarthria persisted. A positron emission tomography-computed tomography brain scan showed decreased 15 F-fludeoxyglucose uptake in bilateral primary motor cortices and in the thalamus, midbrain, and cerebellum. Brain magnetic resonance imaging diffusion tensor imaging and diffusion tensor tractography of the subcortical tracts revealed structural disruptions, especially in the corticospinal tract, dentatorubrothalamic tract, and optic radiation, which seemed to be correlated with the clinical symptoms of the patient. Conclusion This case suggests that the clinical use of diffusion tensor tractography could be helpful to explain the clinical features in the case of SILENT combined with NMS.

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Síndrome de Neurotoxicidade Irreversível Causada por Lítio

Cited by 4 publications

References 3 publications

Levodopa for Syndrome of Irreversible Lithium-Effectuated Neurotoxicity: a SILENT Recovery

Levodopa for Syndrome of Irreversible Lithium-Effectuated Neurotoxicity: a SILENT Recovery

A reappraisal of the role of fever in the occurrence of neurological sequelae following lithium intoxication: a systematic review

Subcortical Structure Disruption in Diffusion Tensor Tractography of the Patient With the Syndrome of Irreversible Lithium-Effectuated Neurotoxicity Combined With Neuroleptic Malignant Syndrome: A Case Report

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