Levine S H, Puchalski C
Department of Psychiatry and Behavioral Sciences, University of Southern California School of Medicine, Los Angeles 90033.
J Clin Psychiatry. 1990 Jun;51(6):251-3.
The authors report two cases of pseudotumor cerebri in patients taking lithium for treatment of bipolar disorder. Pseudotumor cerebri is a poorly understood syndrome characterized by chronic headaches, bilateral papilledema, and increased intracranial pressure without localized neurologic signs or symptoms, intracranial mass, or hydrocephalus. Ventriculography, computed tomography, and nuclear magnetic resonance imaging reveal normal or small ventricles. Multiple etiologies may include Vitamin A toxicity, obesity, head trauma, hypothyroidism or hyperthyroidism, prolonged steroid therapy or its withdrawal, Addison's disease, Cushing's disease, pituitary insufficiency, and lithium therapy. Patients treated with lithium whose antidiuretic hormone-cyclic adenosine monophosphate mechanism is disturbed are most likely to develop pseudotumor cerebri via disregulation of sodium balance, thyroid-stimulating hormone production, and glucose metabolism. The authors recommend careful medical monitoring to avoid iatrogenic effects of lithium, including pseudotumor cerebri.
作者报告了两例在服用锂盐治疗双相情感障碍的患者中发生的假性脑瘤病例。假性脑瘤是一种了解甚少的综合征，其特征为慢性头痛、双侧视乳头水肿以及颅内压升高，而无局部神经体征或症状、颅内肿块或脑积水。脑室造影、计算机断层扫描和核磁共振成像显示脑室正常或变小。多种病因可能包括维生素A中毒、肥胖、头部外伤、甲状腺功能减退或亢进、长期类固醇治疗或停药、艾迪生病、库欣病、垂体功能不全以及锂盐治疗。抗利尿激素 - 环磷酸腺苷机制受到干扰的锂盐治疗患者，最有可能通过钠平衡、促甲状腺激素分泌和葡萄糖代谢失调而发生假性脑瘤。作者建议进行仔细的医学监测，以避免锂盐的医源性效应，包括假性脑瘤。
