A Case Report on an Atypical Presentation of the Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (SILENT) in a War Veteran with Bipolar Disorder and PTSD
Joint Authors
Señga, Miguela Marie
Sarapuddin, Gemmalynn
Saniel, Edmundo
Source
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-06-04
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
Background.
Lithium is still the first-line agent for bipolar disorder.
Despite common knowledge on monitoring lithium levels to prevent toxicity, it still occurs at varying degrees.
Here we present a rare sequela of lithium toxicity, the Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (SILENT).
Case Presentation.
A 56-year-old male war veteran who is fully functional despite being on chronic lithium therapy for Posttraumatic Stress Disorder (PTSD) and bipolar disorder presented at the emergency room with altered mental status and seizures associated with elevated lithium levels and renal insufficiency.
Antiepileptic drugs were given for seizure control, and intermittent hemodialysis was done to clear the lithium.
Despite clearance of the offending agent, the patient remained to have a generalized slowing on repeated EEG with only eye opening and nonpurposeful limb movements regained even after more than 2 months of lithium cessation.
Conclusion.
SILENT has been coined after reports of persistent neurologic deficits were seen in patients who experienced lithium toxicity more than 2 months after cessation of lithium.
Chronic lithium therapy predisposes to gradual accumulation of lithium in the brain.
Demyelination is the typically reported feature of SILENT.
It can also leave the patient in a persistent encephalopathic state.
Chronic lithium toxicity from failure of monitoring puts patients on lithium therapy at risk.
American Psychological Association (APA)
Señga, Miguela Marie& Sarapuddin, Gemmalynn& Saniel, Edmundo. 2020. A Case Report on an Atypical Presentation of the Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (SILENT) in a War Veteran with Bipolar Disorder and PTSD. Case Reports in Psychiatry،Vol. 2020, no. 2020, pp.1-4.
https://search.emarefa.net/detail/BIM-1150903
Modern Language Association (MLA)
Señga, Miguela Marie…[et al.]. A Case Report on an Atypical Presentation of the Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (SILENT) in a War Veteran with Bipolar Disorder and PTSD. Case Reports in Psychiatry No. 2020 (2020), pp.1-4.
https://search.emarefa.net/detail/BIM-1150903
American Medical Association (AMA)
Señga, Miguela Marie& Sarapuddin, Gemmalynn& Saniel, Edmundo. A Case Report on an Atypical Presentation of the Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (SILENT) in a War Veteran with Bipolar Disorder and PTSD. Case Reports in Psychiatry. 2020. Vol. 2020, no. 2020, pp.1-4.
https://search.emarefa.net/detail/BIM-1150903
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1150903