Neurological sequelae following acute lithium poisoning - Review of the literature

Objective: To review the literature on the permanent neurological sequelae resulting from om acute lithium poisoning. Method: Sixty-six articles were reviewed in English and in French. They wer e accessed through Medline and cover the period from 1968 to 1997. Results: Fifty-nine case studies were broken down into 3 groups: lithium in toxications without a neuroleptic that has provoked a cerebellar syndrome; those in which there was a neuroleptic; and those with diverse neurological consequences, with or without a neuroleptic. Conclusions: Lithium has an intrinsic toxicity for the central nervous syst em and provokes a tropism specific to the cerebellum. The association with neuroleptics appears to increase toxicity as well as some associated factor s, including infections and the rapid correction of the lithium level in th e blood. We discuss the psychopathological mechanisms invoked to explain li thium's neurotoxicity.