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Lithium Intoxication as a cause of reversible dementia mimicking FDG PET features of Alzheimer’s disease

Authors :
Alexandre Motta Mecê
Vitor Corsaletti Abreu
Gustavo Manginelli Lamas
Rafaella do Rosário Tacla
Thais Benício Minekawa
Celso Dario Ramos
Marcio Luiz Figueiredo Balthazar
Source :
Dementia & Neuropsychologia, Vol 16, Iss 2, Pp 249-252 (2022)
Publication Year :
2022
Publisher :
Associação Neurologia Cognitiva e do Comportamento, 2022.

Abstract

ABSTRACT. Rapidly progressive dementia (RPD) is a rare neurological disorder. Drug toxicity is among the differential diagnoses, including the use of lithium, in which an overdosage might cause cognitive dysfunction. Clinical suspicion, laboratory confirmation, and drug interruption are key points in the management of lithium intoxication. We described a 66-year-old female patient under treatment with lithium who developed an RPD associated with parkinsonian symptoms. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) showed an “Alzheimer-like” pattern, while cerebrospinal fluid biomarkers for the disease were negative. There was a significant clinical and radiological improvement after lithium interruption. Lithium intoxication is a potentially reversible cause of RPD, as demonstrated in this case report. Drug discontinuation should be considered even in patients with normal levels of this metal, if cognitive impairment is detected. 18F-FDG PET/CT images may show an “Alzheimer-like” image pattern in acute intoxication and are useful for monitoring these patients.

Details

Language :
English
ISSN :
19805764
Volume :
16
Issue :
2
Database :
Directory of Open Access Journals
Journal :
Dementia & Neuropsychologia
Publication Type :
Academic Journal
Accession number :
edsdoj.f98c9c5fe1db48bdb802875551c7a482
Document Type :
article
Full Text :
https://doi.org/10.1590/1980-5764-dn-2021-0105