Roy M, Stip E, Black D, Lew V, Langlois R
Département de Psychiatrie, Hôpital Louis-H. Lafontaine, Université de Montréal.
Rev Neurol (Paris). 1998 Jul;154(6-7):546-8.
Lithium is a neurotoxin with a particular affinity for the cerebellum. The risk of permanent neurotoxic sequelae of lithium is increased by the concomitant use of certain conventional neuroleptics. We report two new cases of lithium neurotoxicity; one received lithium alone, not in combination with a neuroleptic. Both cases showed severe cerebellar atrophy on brain CT and MRI. Additional factors such as dehydration, systemic infection, other medications, or rapid correction of frequently-coexisting hyponatremia may contribute to the risk of lithium neurotoxicity. We discuss possible pathophysiologic mechanisms and preventive measures.
锂是一种对小脑有特殊亲和力的神经毒素。同时使用某些传统抗精神病药物会增加锂导致永久性神经毒性后遗症的风险。我们报告两例新的锂神经毒性病例；其中一例仅接受锂治疗，未与抗精神病药物联用。两例患者的脑部CT和MRI均显示严重的小脑萎缩。脱水、全身感染、其他药物或快速纠正常并存的低钠血症等其他因素可能会增加锂神经毒性的风险。我们讨论了可能的病理生理机制和预防措施。
