Syndrome of Irreversible Lithium – Effectuated Neurotoxicity (Silent Syndrome)
Abstract
SILENT syndrome (Syndrome of Irreversible Lithium-Effectuated Neurotoxicity) is a rare permanent neurological sequelae of lithium toxicity that develops in patients without any previous history of neurological impairment. Most classically it causes a fine, 8–12 Hz postural tremor considered to be an “enhanced” physiological tremor. Cognitive impairment, ataxia, dyskinesia and incoordination may also occur. Despite the availability of newer drugs, lithium remains the most effective treatment for bipolar disorder. But treatmentwith lithium is complicated by its narrow therapeutic index and its effects on renal function, both of which increasesthe risk of toxicity. Hence, careful attention to its administration is needed. Chronic toxic effects of lithium result when the intake exceeds elimination.
Keywords: silent syndrome, lithium toxicity,bipolar disorder.
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