Skip to main content
Erschienen in: The Cerebellum 5-6/2017

01.12.2017 | Review

Permanent Cerebellar Degeneration After Acute Hyperthermia with Non-toxic Lithium Levels: a Case Report and Review of Literature

verfasst von: Fabian H. Rossi, Elisa Marie Rossi, Michael Hoffmann, Welwin Liu, Ramon Rodriguez Cruz, Natasha Antonovich, Arash Rezaei, Elizabeth Gonzalez, Maria Clara Franco, Alvaro Estevez, Florian Thomas

Erschienen in: The Cerebellum | Ausgabe 5-6/2017

Einloggen, um Zugang zu erhalten

Abstract

This was a study of a 33-year-old man with bipolar disorder treated with lithium who developed cerebellar atrophy after an event of extreme hyperthermia. Unlike previously reported cases of acute cerebellar atrophy after heat stroke, neuroleptic syndrome or lithium toxicity, this case was characterized by a chronic cerebellar atrophy that developed after sepsis-induced hyperthermia in the setting of non-toxic lithium levels. Unique to this case also was the early finding of cerebellar atrophy on MRI 2 weeks after the episode of hyperthermia, long-term neurotoxicity after the novo lithium therapy, and longest follow-up case of chronic cerebellar syndrome after hyperthermia with non-toxic lithium levels.
Literatur
1.
Zurück zum Zitat Snell R. The cerebellum and its connections. In: Clinical Neuroanatomy LWW; 2009. p. 230–50. Snell R. The cerebellum and its connections. In: Clinical Neuroanatomy LWW; 2009. p. 230–50.
2.
Zurück zum Zitat Subramony SH, Xia G. Disorders of the cerebellum including degenerative ataxias. In: Bradley’s neurology in clinical practice. 6th ed: Elsevier Saunders; 2012. p. 1802–23. Subramony SH, Xia G. Disorders of the cerebellum including degenerative ataxias. In: Bradley’s neurology in clinical practice. 6th ed: Elsevier Saunders; 2012. p. 1802–23.
3.
Zurück zum Zitat Victor M, Adams R. ataxia and disorders of the cerebellar function. In: Principles of neurology. 10th ed: McGraw Hill; 2014. p. 81–91. Victor M, Adams R. ataxia and disorders of the cerebellar function. In: Principles of neurology. 10th ed: McGraw Hill; 2014. p. 81–91.
4.
Zurück zum Zitat Kempen V. Intoxication of the neurological system. In: In Vinken PJ, Bruyn GW, de Wolff FA Handbook of clinical neurology: Elsevier Science; 1994. p. 293–301. Kempen V. Intoxication of the neurological system. In: In Vinken PJ, Bruyn GW, de Wolff FA Handbook of clinical neurology: Elsevier Science; 1994. p. 293–301.
6.
Zurück zum Zitat Niethammer M, Ford B. Permanent lithium-induced cerebellar toxicity: three cases and review of literature. Mov Disord. 2007;22(4):570–3.CrossRefPubMed Niethammer M, Ford B. Permanent lithium-induced cerebellar toxicity: three cases and review of literature. Mov Disord. 2007;22(4):570–3.CrossRefPubMed
7.
Zurück zum Zitat Naranja D, et al. Permanent neurologic sequela due to lithium toxicity. Clin Neurol Neurosug. 1987;89:31–4. Naranja D, et al. Permanent neurologic sequela due to lithium toxicity. Clin Neurol Neurosug. 1987;89:31–4.
8.
Zurück zum Zitat Tharoor H, et al. Lithium-neuroleptic combination leading to permanent neurological sequelae? German J Psychiatry. 2007;10:18–20. Tharoor H, et al. Lithium-neuroleptic combination leading to permanent neurological sequelae? German J Psychiatry. 2007;10:18–20.
9.
Zurück zum Zitat Ozsoy S, Basturk M, Esel E. Cerebellar syndrome in a patient with pneumonia under lithium treatment: case report. Prog Neuro Psychopharmacol Biol Psychiatry. 2006;30:1532–4.CrossRef Ozsoy S, Basturk M, Esel E. Cerebellar syndrome in a patient with pneumonia under lithium treatment: case report. Prog Neuro Psychopharmacol Biol Psychiatry. 2006;30:1532–4.CrossRef
10.
Zurück zum Zitat Pelletier J, Habib M, Pellisier JF, et al. Sequelles neurologiques de l'association neuroleptiques-lithium: role de l'hyperthermie. Rev Med Interne. 1991;12:187–91.CrossRefPubMed Pelletier J, Habib M, Pellisier JF, et al. Sequelles neurologiques de l'association neuroleptiques-lithium: role de l'hyperthermie. Rev Med Interne. 1991;12:187–91.CrossRefPubMed
11.
Zurück zum Zitat Rodriguez de Cerqueira AC, Dos Reis MC, et al. Cerebellar degeneration secondary to acute lithium carbonate intoxication. Arq Neuropsiquiatr. 2008;66(3-A):578–80.CrossRef Rodriguez de Cerqueira AC, Dos Reis MC, et al. Cerebellar degeneration secondary to acute lithium carbonate intoxication. Arq Neuropsiquiatr. 2008;66(3-A):578–80.CrossRef
12.
Zurück zum Zitat Schou M. Long-lasting neurological sequela after lithium intoxication. Acta Psych Scand. 1984;70:594–601.CrossRef Schou M. Long-lasting neurological sequela after lithium intoxication. Acta Psych Scand. 1984;70:594–601.CrossRef
13.
Zurück zum Zitat Donaldson IM, Cuningham J. Persistent neurological sequelae of lithium carbonate therapy. Arch Neurol. 1983;40:747–51.CrossRefPubMed Donaldson IM, Cuningham J. Persistent neurological sequelae of lithium carbonate therapy. Arch Neurol. 1983;40:747–51.CrossRefPubMed
14.
Zurück zum Zitat Apte SN, Langston JW. Permanent neurological deficits due to lithium toxicity. Ann Neurol. 1983;13:453–5.CrossRefPubMed Apte SN, Langston JW. Permanent neurological deficits due to lithium toxicity. Ann Neurol. 1983;13:453–5.CrossRefPubMed
15.
Zurück zum Zitat Von Hartitzsch B, Hoenich NA, Leigh RJ, et al. Permanent neurological sequelae despite hemodialysis for lithium intoxication. BMJ. 1972;4:757–9.CrossRef Von Hartitzsch B, Hoenich NA, Leigh RJ, et al. Permanent neurological sequelae despite hemodialysis for lithium intoxication. BMJ. 1972;4:757–9.CrossRef
16.
Zurück zum Zitat Green JB. Permanent neurological deficit resulting from lithium toxicity. Ann Neurol. 1984;15(1):111.CrossRefPubMed Green JB. Permanent neurological deficit resulting from lithium toxicity. Ann Neurol. 1984;15(1):111.CrossRefPubMed
17.
Zurück zum Zitat Hay G, Simpson N. Neurotoxicity associated with therapeutic serum lithium levels. Lancet. 1982;17:160–1.CrossRef Hay G, Simpson N. Neurotoxicity associated with therapeutic serum lithium levels. Lancet. 1982;17:160–1.CrossRef
18.
Zurück zum Zitat Grignon S, Bruguereolle B. Cerebellar lithium toxicity : a review of recent literature and tentative pathophysiology. Therapie. 1996;51:101–6.PubMed Grignon S, Bruguereolle B. Cerebellar lithium toxicity : a review of recent literature and tentative pathophysiology. Therapie. 1996;51:101–6.PubMed
19.
Zurück zum Zitat Roy M. et al. Degenerescence cerebelleuse secondaire a une intoxication aigue au lithium. 1998;154:6–7. 546-548 Roy M. et al. Degenerescence cerebelleuse secondaire a une intoxication aigue au lithium. 1998;154:6–7. 546-548
20.
Zurück zum Zitat Simard M, Gumbiner B, Lee A, et al. Lithium carbonate intoxication. A case report and review of the literature. Arch Int Med. 1989;149:36–46.CrossRef Simard M, Gumbiner B, Lee A, et al. Lithium carbonate intoxication. A case report and review of the literature. Arch Int Med. 1989;149:36–46.CrossRef
21.
Zurück zum Zitat Cohen WJ, Cohen NH. Lithium carbonate, haloperidol, and irreversible brain damage. JAMA. 1974;230:1283–7.CrossRefPubMed Cohen WJ, Cohen NH. Lithium carbonate, haloperidol, and irreversible brain damage. JAMA. 1974;230:1283–7.CrossRefPubMed
22.
Zurück zum Zitat Ferbert A, Czernik A. [persistent cerebellar syndrome following lithium poisoning] in German. Nervenarzi. 1987;58:764–84. Ferbert A, Czernik A. [persistent cerebellar syndrome following lithium poisoning] in German. Nervenarzi. 1987;58:764–84.
24.
Zurück zum Zitat Schneider JA, Mirra S. Neuropathologic correlates of persistent neurologic deficit in lithium intoxication. Ann Neurol. 1994;36:928–31.CrossRefPubMed Schneider JA, Mirra S. Neuropathologic correlates of persistent neurologic deficit in lithium intoxication. Ann Neurol. 1994;36:928–31.CrossRefPubMed
25.
Zurück zum Zitat Mangano WE, Montine TJ, Hulette CM. Pathologic assessment of cerebellar atrophy following acute lithium intoxication. Clin Neuropathol. 1997;16(1):30–3.PubMed Mangano WE, Montine TJ, Hulette CM. Pathologic assessment of cerebellar atrophy following acute lithium intoxication. Clin Neuropathol. 1997;16(1):30–3.PubMed
26.
Zurück zum Zitat Dixon JF, Georgyi V, Hokin LE. Lithium stimulate glutamate “release” and inositol 1,4,5-trisphosphate accumulation via activation of the N-methyl-D-aspartate receptor in monkey and mouse cerebral cortex slices. Proc Natl Acad Sci. 1994;91:8358–62.CrossRefPubMedPubMedCentral Dixon JF, Georgyi V, Hokin LE. Lithium stimulate glutamate “release” and inositol 1,4,5-trisphosphate accumulation via activation of the N-methyl-D-aspartate receptor in monkey and mouse cerebral cortex slices. Proc Natl Acad Sci. 1994;91:8358–62.CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Lee S, et al. Cerebellar degeneration in neuroleptic malignant syndrome: neuropathological findings and review of the literature concerning heat-related nervous system injury. J Neurol Neurosurg Psychiatry. 1989;52:387–91.CrossRefPubMedPubMedCentral Lee S, et al. Cerebellar degeneration in neuroleptic malignant syndrome: neuropathological findings and review of the literature concerning heat-related nervous system injury. J Neurol Neurosurg Psychiatry. 1989;52:387–91.CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Victor M, Adams R. Acquired metabolic disorders of the nervous system. Effects of hyperthermia on cerebellum. In: Principles of neurology. 10th ed: McGraw Hill; 2014. p. 1132–60. Victor M, Adams R. Acquired metabolic disorders of the nervous system. Effects of hyperthermia on cerebellum. In: Principles of neurology. 10th ed: McGraw Hill; 2014. p. 1132–60.
29.
Zurück zum Zitat Emilien G, Maloteaux JM. Lithium neurotoxicity at low therapeutic doses hypotheses for causes and mechanism of action following a retrospective analysis of published case reports. Acta Neurol Belg. 1996;96:281–93.PubMed Emilien G, Maloteaux JM. Lithium neurotoxicity at low therapeutic doses hypotheses for causes and mechanism of action following a retrospective analysis of published case reports. Acta Neurol Belg. 1996;96:281–93.PubMed
31.
Zurück zum Zitat Forlenza OV, Novaes Coutinho AM, Aprahamian I, et al. Long-term lithium treatment reduces glucose metabolism in the cerebellum and hippocampus of nondemented older adults: an [18f]FDG-PET study. ACS Chem Neuroci. 2014;5:484–9.CrossRef Forlenza OV, Novaes Coutinho AM, Aprahamian I, et al. Long-term lithium treatment reduces glucose metabolism in the cerebellum and hippocampus of nondemented older adults: an [18f]FDG-PET study. ACS Chem Neuroci. 2014;5:484–9.CrossRef
32.
Zurück zum Zitat Altschul E, Grossman C, Dougherty R, Gaikwad R, Nguyen V, Schwimmer J, et al. Lithium toxicity: a review of pathophysiology, treatment, and prognosis. Pract Neurol. 2016:42–5. Altschul E, Grossman C, Dougherty R, Gaikwad R, Nguyen V, Schwimmer J, et al. Lithium toxicity: a review of pathophysiology, treatment, and prognosis. Pract Neurol. 2016:42–5.
33.
Zurück zum Zitat Greller HA., Howard A. Lithium. In: Hoffman RS, Howland M, Lewin NA, Nelson LS, Goldfrank LR. Hoffman R.S., Howland M, Lewin N.A., Nelson L.S., Goldfrank L.R. Eds. Robert S. Hoffman, et al. eds. Goldfrank’s Toxicologic Emergencies, 10e New York, McGraw-Hill; 2015. Chapter 72 (e-book). Greller HA., Howard A. Lithium. In: Hoffman RS, Howland M, Lewin NA, Nelson LS, Goldfrank LR. Hoffman R.S., Howland M, Lewin N.A., Nelson L.S., Goldfrank L.R. Eds. Robert S. Hoffman, et al. eds. Goldfrank’s Toxicologic Emergencies, 10e New York, McGraw-Hill; 2015. Chapter 72 (e-book).
34.
Zurück zum Zitat Smith SW, Ling LJ, Halstenson CE. Whole-bowel irrigation as a treatment for acute lithium overdose. Ann Emerg Med. 1991;20(5):536.CrossRefPubMed Smith SW, Ling LJ, Halstenson CE. Whole-bowel irrigation as a treatment for acute lithium overdose. Ann Emerg Med. 1991;20(5):536.CrossRefPubMed
35.
Zurück zum Zitat Thanacoody R, Caravati EM, Troutman B, Höjer J, Benson B, Hoppu K. Position paper update: whole bowel irrigation for gastrointestinal decontamination of overdose patients. Clin Toxicol (Phila). 2015;53(1):5.CrossRefPubMed Thanacoody R, Caravati EM, Troutman B, Höjer J, Benson B, Hoppu K. Position paper update: whole bowel irrigation for gastrointestinal decontamination of overdose patients. Clin Toxicol (Phila). 2015;53(1):5.CrossRefPubMed
36.
Zurück zum Zitat Bélanger DR, Tierney MG, Dickinson G. Effect of sodium polystyrene sulfonate on lithium bioavailability. Ann Emerg Med. 1992;21(11):1312.CrossRefPubMed Bélanger DR, Tierney MG, Dickinson G. Effect of sodium polystyrene sulfonate on lithium bioavailability. Ann Emerg Med. 1992;21(11):1312.CrossRefPubMed
37.
Zurück zum Zitat Ghannoum M, Lavergne V, Yue CS, Ayoub P, Perreault MM, Roy L. Successful treatment of lithium toxicity with sodium polystyrene sulfonate: a retrospective cohort study. Clin Toxicol (Phila). 2010;48(1):34.CrossRef Ghannoum M, Lavergne V, Yue CS, Ayoub P, Perreault MM, Roy L. Successful treatment of lithium toxicity with sodium polystyrene sulfonate: a retrospective cohort study. Clin Toxicol (Phila). 2010;48(1):34.CrossRef
38.
Zurück zum Zitat Kasahara H, Shinozaki T, Nukariya K, Nishimura H, et al. Hemodialysis for lithium intoxication: preliminary guidelines for emergency. Jpn J Psychiatry Neurol. 1994;48:1–12.PubMed Kasahara H, Shinozaki T, Nukariya K, Nishimura H, et al. Hemodialysis for lithium intoxication: preliminary guidelines for emergency. Jpn J Psychiatry Neurol. 1994;48:1–12.PubMed
39.
Zurück zum Zitat Decker BS, Goldfarb DS, Dargan PI, Fiesen MGosselin S, Hoffman RS, Ghannoum M, et al. Extracorporeal treatment for lithium poisoning: systematic review and recommendations from the EXTRIP workgroup. Clin J Am Soc Nephrol. 2015;10(5):875–87.CrossRefPubMedPubMedCentral Decker BS, Goldfarb DS, Dargan PI, Fiesen MGosselin S, Hoffman RS, Ghannoum M, et al. Extracorporeal treatment for lithium poisoning: systematic review and recommendations from the EXTRIP workgroup. Clin J Am Soc Nephrol. 2015;10(5):875–87.CrossRefPubMedPubMedCentral
40.
Zurück zum Zitat Vermiere S, Vanbrabant P, Van Boxstael P, Sabbe M. Severity (and treatment) of chronic lithium poisoning: clinical signs or lab results as criterion? Acta Clin Belg. 2010;65(2):127–8.CrossRef Vermiere S, Vanbrabant P, Van Boxstael P, Sabbe M. Severity (and treatment) of chronic lithium poisoning: clinical signs or lab results as criterion? Acta Clin Belg. 2010;65(2):127–8.CrossRef
41.
Zurück zum Zitat Borras-Blasco J, Sirvent AE, Navarro Ruiz A, et al. Unrecognized delayed toxic lithium peak concentration in acute poisoning with sustained release lithium product. South Med J. 2007;100:321–3.CrossRefPubMed Borras-Blasco J, Sirvent AE, Navarro Ruiz A, et al. Unrecognized delayed toxic lithium peak concentration in acute poisoning with sustained release lithium product. South Med J. 2007;100:321–3.CrossRefPubMed
42.
Zurück zum Zitat Friedberg RC, Spyker DA, Herod DA. Massive overdoses with sustained-release lithium carbonate preparations: pharmacokinetic model based on two studies. Clin Chem. 1991;37:1205–9.PubMed Friedberg RC, Spyker DA, Herod DA. Massive overdoses with sustained-release lithium carbonate preparations: pharmacokinetic model based on two studies. Clin Chem. 1991;37:1205–9.PubMed
43.
Zurück zum Zitat Timmer RT, Sands JM. Lithium intoxication. J Am Soc Nephrol. 1999;10(3):666–74.PubMed Timmer RT, Sands JM. Lithium intoxication. J Am Soc Nephrol. 1999;10(3):666–74.PubMed
44.
Zurück zum Zitat Bellomo R, Kearly Y, Parkin G, Love J, Boyce N. Treatment of life-threatening lithium toxicity with continuous arterio-venous hemodiafiltration. Crit Care Med. 1991;19(6):836–7.CrossRefPubMed Bellomo R, Kearly Y, Parkin G, Love J, Boyce N. Treatment of life-threatening lithium toxicity with continuous arterio-venous hemodiafiltration. Crit Care Med. 1991;19(6):836–7.CrossRefPubMed
45.
Zurück zum Zitat Leblanc M, Raymond M, Bonnardeaux A, Isenring P, Pichette V, Geadah D. Lithium poisoning treated by high-performance continuous arteriovenous and venovenous hemodiafiltration. Am J Kidney Dis. 1996;27(3):365.CrossRefPubMed Leblanc M, Raymond M, Bonnardeaux A, Isenring P, Pichette V, Geadah D. Lithium poisoning treated by high-performance continuous arteriovenous and venovenous hemodiafiltration. Am J Kidney Dis. 1996;27(3):365.CrossRefPubMed
46.
Zurück zum Zitat Garlich FM, Goldfab DS. Have advances in extracorporeal removal techniques changes the indication for the use in poisoning? Adv Chronic Kidney Dis. 2011;18:172–9.CrossRefPubMed Garlich FM, Goldfab DS. Have advances in extracorporeal removal techniques changes the indication for the use in poisoning? Adv Chronic Kidney Dis. 2011;18:172–9.CrossRefPubMed
47.
Zurück zum Zitat Beckman U, Oakley PW. Dawson AH efficacy of continuous venovenous hemodialysis in the treatment of sever lithium toxicity. J Toxicol Clin Toxicol. 2001;39(4):393–7.CrossRef Beckman U, Oakley PW. Dawson AH efficacy of continuous venovenous hemodialysis in the treatment of sever lithium toxicity. J Toxicol Clin Toxicol. 2001;39(4):393–7.CrossRef
48.
Zurück zum Zitat Meertens JHJM, Jagernath DR, Elevelend DJ. Hemodialysis followed by continuous veno-venous hemadialfiltartion in lithium intoxication: a model and a case. Eur J Intern Med. 2009;20:e70–3.CrossRefPubMed Meertens JHJM, Jagernath DR, Elevelend DJ. Hemodialysis followed by continuous veno-venous hemadialfiltartion in lithium intoxication: a model and a case. Eur J Intern Med. 2009;20:e70–3.CrossRefPubMed
Metadaten
Titel
Permanent Cerebellar Degeneration After Acute Hyperthermia with Non-toxic Lithium Levels: a Case Report and Review of Literature
verfasst von
Fabian H. Rossi
Elisa Marie Rossi
Michael Hoffmann
Welwin Liu
Ramon Rodriguez Cruz
Natasha Antonovich
Arash Rezaei
Elizabeth Gonzalez
Maria Clara Franco
Alvaro Estevez
Florian Thomas
Publikationsdatum
01.12.2017
Verlag
Springer US
Erschienen in
The Cerebellum / Ausgabe 5-6/2017
Print ISSN: 1473-4222
Elektronische ISSN: 1473-4230
DOI
https://doi.org/10.1007/s12311-017-0868-3

Weitere Artikel der Ausgabe 5-6/2017

The Cerebellum 5-6/2017 Zur Ausgabe

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Schützt Olivenöl vor dem Tod durch Demenz?

10.05.2024 Morbus Alzheimer Nachrichten

Konsumieren Menschen täglich 7 Gramm Olivenöl, ist ihr Risiko, an einer Demenz zu sterben, um mehr als ein Viertel reduziert – und dies weitgehend unabhängig von ihrer sonstigen Ernährung. Dafür sprechen Auswertungen zweier großer US-Studien.

Bluttest erkennt Parkinson schon zehn Jahre vor der Diagnose

10.05.2024 Parkinson-Krankheit Nachrichten

Ein Bluttest kann abnorm aggregiertes Alpha-Synuclein bei einigen Menschen schon zehn Jahre vor Beginn der motorischen Parkinsonsymptome nachweisen. Mit einem solchen Test lassen sich möglicherweise Prodromalstadien erfassen und die Betroffenen früher behandeln.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Wartezeit nicht kürzer, aber Arbeit flexibler

Psychotherapie Medizin aktuell

Fünf Jahren nach der Neugestaltung der Psychotherapie-Richtlinie wurden jetzt die Effekte der vorgenommenen Änderungen ausgewertet. Das Hauptziel der Novellierung war eine kürzere Wartezeit auf Therapieplätze. Dieses Ziel wurde nicht erreicht, es gab jedoch positive Auswirkungen auf andere Bereiche.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.