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Cognitive sequelae of lithium intoxication: a case report

Published online by Cambridge University Press:  24 April 2017

Stefan Frisch Open the ORCID record for Stefan Frisch [Opens in a new window] ,
Frank Grünwald  and
Benedikt Friedrichs
Stefan Frisch*
Affiliation:
Department of Neurology, University Hospital Frankfurt/Goethe University, Frankfurt am Main, Germany
Frank Grünwald
Affiliation:
Department of Nuclear Medicine, University Hospital Frankfurt/Goethe University, Frankfurt am Main, Germany
Benedikt Friedrichs
Affiliation:
Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt/Goethe University, Frankfurt am Main, Germany
*
Correspondence should be addressed to: Dr. Stefan Frisch, Institute of Psychology, Goethe University, Theodor-W.-Adorno-Platz 6, 60629 Frankfurt am Main, Germany. Phone: +49-69-798-35406; Email: frisch@med.uni-frankfurt.de.
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Abstract

Lithium intoxication is known to induce cognitive deficits along with motor and behavioral changes, even in association with normal serum levels. However, cases with comprehensive neuropsychological assessment of the deficits are rare. In our patient, we initially found severe cognitive deficits, including apraxia and visuo-constructive problems, and temporo-parietal FDG–PET hypometabolism. Neuropsychological and imaging findings were highly suggestive of Alzheimer's disease. However, lithium intoxication was suspected to account for these findings because of a Parkinson's syndrome, despite serum levels being in the upper therapeutic range. This was confirmed as cessation of lithium medication not only let the Parkinson's syndrome disappear, but also lead to dramatic improvements with respect to cognition.

Keywords

lithium intoxicationcognitive deficitsneuropychologypositron emission tomography (PET)
Type
Case Report
Information
International Psychogeriatrics , Volume 29 , Issue 10 , October 2017 , pp. 1747 - 1751
Copyright
Copyright © International Psychogeriatric Association 2017 

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