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CC BY-NC-ND 4.0 · International Journal of Epilepsy
DOI: 10.1055/s-0044-1779695
Case Report

New Onset Encephalopathy with Toxic Triphasic Waves

Amrutha PC
1   Department of Neurosciences, Meitra Hospital, Calicut, Kerala, India
,
Poornima Narayanan Nambiar 
1   Department of Neurosciences, Meitra Hospital, Calicut, Kerala, India
,
Navaf KM
2   Department of Critical Care Medicine, Meitra Hospital, Calicut, Kerala, India
,
Sarfaraz Aslam
3   Department of Nephrology, Meitra Hospital, Calicut, Kerala, India
,
Krishnadas NC
1   Department of Neurosciences, Meitra Hospital, Calicut, Kerala, India
,
Deep P Pillai
1   Department of Neurosciences, Meitra Hospital, Calicut, Kerala, India
,
Sachin Sureshbabu
1   Department of Neurosciences, Meitra Hospital, Calicut, Kerala, India
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Abstract

New onset encephalopathy can have various causes like stroke, trauma, seizures, infections, demyelination, neoplasms, autoimmune, degenerative, and toxic and metabolic etiologies. Triphasic waves in electroencephalogram (EEG) is usually a clue to an ongoing metabolic process. We report a case of a 69-year-old female with bipolar disorder who presented with altered sensorium for the last 2 days. Her metabolic parameters, imaging, and cerebrospinal fluid findings were normal. Her EEG findings in the clinical setting provided a diagnostic clue to lithium toxicity, even though her serum lithium levels were normal. As her sensorium was progressively worsening, she was given a trial of hemodialysis with which she had significant improvement.

Keywords

encephalopathy - lithium toxicity - triphasic waves


Publication History

Article published online:
26 February 2024

© 2024. Indian Epilepsy Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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