CEREBELLAR DEGENERATION FOLLOWING ACUTE LITHIUM INTOXICATION

Lithium is a neurotoxin with a particular affinity for the cerebellum. The risk of permanent neurotoxic sequelae of lithium is increased by the comcomitant use of certain conventional neuroleptics. We report tw o new cases of lithium neurotoxicity; one received lithium alone, not in combination with a neuroleptic. Both cases showed severe cerebellar atrophy on brain CT and MRI. Additional factors such as dehydration, systemic infection, other medications, or rapid correction of frequenc y-coexisting hyponatremia may contribute to the risk of lithium neurot oxicity. We discuss possible pathophysiologic mechanisms and preventiv e measures.