Acute lithium neurotoxicity.

Two hundred and thirteen published case reports of acute lithium (Li) toxicity occurring between 1948 and 1984 are reviewed. Although chronic Li may cause toxic effects in a variety of organs, acute toxic effects are manifested mainly in the central nervous system (CNS). CNS depression is reflected in decreased upper motor neuron control, decreased level of consciousness, and slowing on the electroencephalogram. Permanent or long-lived neurological sequelae may occur in as much as a third of all cases. The outcome of toxicity is a function of maximum Li levels and promptness and efficacy of therapy.