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Cognitive sequelae of lithium intoxication: a case report

  • Stefan Frisch (a1), Frank Grünwald (a2) and Benedikt Friedrichs (a3)


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.


Corresponding author

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:


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Adityanjee Munshi, K. R. and Thampy, A. (2005). The syndrome of irreversible lithium-effectuated neurotoxicity. Clinical Neuropharmacology, 28, 3849.
Bartha, L., Marksteiner, J., Bauer, G. and Benke, T. (2002). Persistent cognitive deficits associated with lithium intoxication: a neuropsychological case description. Cortex, 38, 743752.
Berti, V., Pupi, A. and Mosconi, L. (2011). PET/CT in diagnosis of movement disorders. Annals of the New York Academy of Sciences, 1228, 93108.
Bondon-Guitton, E., Perez-Lloret, S., Bagheri, H., Brefel, C., Rascol, O. and Montastruc, J. L. (2011). Drug-induced parkinsonism: a review of 17 years' experience in a regional pharmacovigilance center in France. Movement Disorders, 26, 22262231.
Dubois, B. et al. (2007). Research criteria for the diagnosis of Alzheimer's disease: revising the NINCDS-ADRDA criteria. Lancet Neurology, 6, 734746.
Grandjean, E. M. and Aubry, J. M. (2009). Lithium: updated human knowledge using an evidence-based approach: part III: clinical safety. CNS Drugs, 23, 397418.
Hoffman, J. M. et al. (2000). FDG PET imaging in patients with pathologically verified dementia. Journal of Nuclear Medicine, 41, 19201928.
Holroyd, S. and Smith, D. (1995). Disabling parkinsonism due to lithium: a case report. Journal of Geriatric Psychiatry and Neurology, 8, 118119.
Kores, B. and Lader, M. H. (1997). Irreversible lithium neurotoxicity: an overview. Clinical Neuropharmacolology, 20, 283299.
McGirt, M. J., Woodworth, G., Coon, A. L., Thomas, G., Williams, M. A. and Rigamonti, D. (2005). Diagnosis, treatment, and analysis of long-term outcomes in idiopathic normal-pressure hydrocephalus. Neurosurgery, 57, 699705.
Naranjo, C. A. et al. (1981). A method for estimating the probability of adverse drug reactions. Clinical Pharmacolology and Therapeutics, 30, 239245.
Schroeter, M. L., Stein, T., Maslowski, N. and Neumann, J. (2009). Neural correlates of Alzheimer's disease and mild cognitive impairment: a systematic and quantitative meta-analysis involving 1351 patients. Neuroimage, 47, 11961206.
Tonn, P., Bartenstein, P. and Dahmen, N. (2005). Lithium intoxication mimics Alzheimer's disease in PET and clinical findings. Nervenarzt, 76, 613616.


Cognitive sequelae of lithium intoxication: a case report

  • Stefan Frisch (a1), Frank Grünwald (a2) and Benedikt Friedrichs (a3)


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