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DOI: 10.1055/s-0044-1779695
New Onset Encephalopathy with Toxic Triphasic Waves
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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.
Publikationsverlauf
Artikel online veröffentlicht:
26. Februar 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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References
- 1 Erkkinen MG, Berkowitz AL. A clinical approach to diagnosing encephalopathy. Am J Med 2019; 132 (10) 1142-1147
- 2 Carmassi C, Nardi B, Battaglini S. et al. A case of lithium encephalopathy with therapeutic lithium levels: the diagnostic role of EEG. Case Rep Psychiatry 2022; 2022: 8052471
- 3 Sharma S, Joshi S, Chadda RK. Therapeutic drug monitoring of lithium in patients with bipolar affective disorder: experiences from a tertiary care hospital in India. Am J Ther 2009; 16 (05) 393-397
- 4 Young W. Review of lithium effects on brain and blood. Cell Transplant 2009; 18 (09) 951-975
- 5 McKnight RF, Adida M, Budge K, Stockton S, Goodwin GM, Geddes JR. Lithium toxicity profile: a systematic review and meta-analysis. Lancet 2012; 379 (9817): 721-728
- 6 Adityanjee. The syndrome of irreversible lithium-effectuated neurotoxicity (SILENT). Pharmacopsychiatry 1989; 22 (02) 81-83
- 7 Kaplan PW, Birbeck G. Lithium-induced confusional states: nonconvulsive status epilepticus or triphasic encephalopathy?. Epilepsia 2006; 47 (12) 2071-2074
- 8 Madhusudhan BK. Nonconvulsive status epilepticus and Creutzfeldt-Jakob-like EEG changes in a case of lithium toxicity. Epilepsy Behav Case Rep 2014; 2: 203-205
- 9 Crammer JL, Rosser RM, Crane G. Blood levels and management of lithium treatment. BMJ 1974; 3 (5932): 650-654
- 10 Camus M, Henneré G, Baron G. et al. Comparison of lithium concentrations in red blood cells and plasma in samples collected for TDM, acute toxicity, or acute-on-chronic toxicity. Eur J Clin Pharmacol 2003; 59 (8-9): 583-587