Eine mögliche Langzeitfolge einer Lithiumintoxikation ist das sog. SILENT-Syndrom.Dabei entwickeln die Patienten trotz erfolgreicher Elimination von Lithium persistierende neurologische und neuropsychiatrische Symptome. Ein SILENT-Syndrom kann Monate und in seltenen Fällen Jahre bestehen.
Following discontinuation of lithium and hemodialysis, the patient’s symptoms remained static. The patient was diagnosed with syndrome of irreversible lithium-effectuated neurotoxicity (SILENT), a chronic cerebellar disorder characterized by persistent ataxia, nystagmus, and gait abnormalities extending beyond two months post-lithium exposure.
Although the use of lithium has become much more stringent than it has been in past years, and the occurrence of SILENT is rather exceptional, raising awareness about SILENT nevertheless remains crucial to avoid deleterious neurological consequences. This requires, in the first instance, a precise clinical description of the syndrome.
The Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (SILENT) is a rare but concerning neurological complication resulting from lithium intoxication. Despite being reported since the 1960s, SILENT remains poorly understood and previous reviews on this topic commonly have been narrative.
To review the long-term neurological sequelae of lithium intoxication (SILENT) to highlight their clinical presentation, assessment, management and preventive measures. Non-systematic review of literature through search on PubMed/MEDLINE for publications up to 2021, following the terms syndrome of irreversible lithium-effectuated neurotoxicity.
Neurological manifestations of lithium poisoning may persist, even after effective removal of the drug – SILENT. The most frequent sequelae are cerebellum and brain stem dysfunction, extrapyramidal symptoms and dementia. They may last for weeks, months or years.
Complications from the use of lithium known in the medical literature include mainly nephrotoxicity, endocrine alterations and neurotoxicity. The neurotoxic effects of lithium usually occur at high serum concentrations.
Eine mögliche Langzeitfolge einer Lithiumintoxikation ist das sog. SILENT-Syndrom.Dabei entwickeln die Patienten trotz erfolgreicher Elimination von Lithium persistierende neurologische und neuropsychiatrische Symptome. Ein SILENT-Syndrom kann Monate und in seltenen Fällen Jahre bestehen.
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Get PriceKey information concerning clinical manifestations, risk factors, therapeutic approaches, or preventive measurements was extracted. We reviewed 91 articles, extracting …
Get PriceLithium and valproic acid levels were found to be within normal limits. Imaging studies, including CT head and MRI brain were both negative, without any signs of ventriculomegaly, while EEG …
Get PriceSILENT (Syndrome of Irreversible Lithium-Effectuated NeuroToxicity) Potentially permanent neurologic injury resulting from lithium toxicity, due to an unclear mechanism. Manifestations may include cerebellar …
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Get PriceKey information concerning clinical manifestations, risk factors, therapeutic approaches, or preventive measurements was extracted. We reviewed 91 articles, extracting information from 117 cases of SILENT. The prevailing outcome observed was persistent cerebellar dysfunction (77% of cases), often in combination with other sequelae ...
Get PriceSILENT, a preventable though permanent cerebellar syndrome, underscores the need for vigilance and management of lithium levels in ICU patients, particularly with renal impairment. Recognizing this risk, monitoring drug levels, and discontinuing lithium if needed, can mitigate the risk, and reduce morbidity. .
Get PriceSILENT (Syndrome of Irreversible Lithium-Effectuated NeuroToxicity) Potentially permanent neurologic injury resulting from lithium toxicity, due to an unclear mechanism. Manifestations may include cerebellar dysfunction and cognitive dysfunction. SILENT is more common with chronic intoxication than acute toxicity. It may result from ...
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Get PriceThe clinical profile of SILENT varies, but persistent cerebellar dysfunction is the most common finding, with extrapyramidal symptoms also typically present. Many of these cases involve insidious progression in …
Get PriceThe clinical profile of SILENT varies, but persistent cerebellar dysfunction is the most common finding, with extrapyramidal symptoms also typically present. Many of these cases involve insidious progression in patients on normal or low therapeutic levels of lithium .
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Get PriceSILENT, a preventable though permanent cerebellar syndrome, underscores the need for vigilance and management of lithium levels in ICU patients, particularly with renal …
Get PriceThe term ''SILENT'' explains descriptively persistent neurological sequelae related to lithium salt intoxication when symptoms persist for more than 2 months after …
Get PriceNeurological manifestations of lithium poisoning may persist, even after effective removal of the drug – SILENT. The most frequent sequelae are cerebellum and brain stem dysfunction, extrapyramidal symptoms and dementia. They may last for weeks, months or years.
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Get PriceNeurological manifestations of lithium poisoning may persist, even after effective removal of the drug – SILENT. The most frequent sequelae are cerebellum and brain stem …
Get PriceDespite being reported since the 1960s, SILENT remains poorly understood and previous reviews on this topic commonly have been narrative. We therefore conducted a scoping review to assess the nature and scope of the research literature on the long-term neurological sequelae of lithium toxicity and determine the current knowledge of SILENT.
Get PriceThe term ''SILENT'' explains descriptively persistent neurological sequelae related to lithium salt intoxication when symptoms persist for more than 2 months after stopping treatment.
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Get PriceSILENT: The syndrome of irreversible lithium-effectuated neurotoxicity: A case report with two years follow-up Clin Neurol Neurosurg . 2020 Aug:195:106057. doi: 10.1016/j.clineuro.2020.106057.
Get PriceSILENT: The syndrome of irreversible lithium-effectuated neurotoxicity: A case report with two years follow-up Clin Neurol Neurosurg . 2020 Aug:195:106057. doi: …
Get PriceDespite being reported since the 1960s, SILENT remains poorly understood and previous reviews on this topic commonly have been narrative. We therefore conducted a scoping review to …
Get PriceLithium and valproic acid levels were found to be within normal limits. Imaging studies, including CT head and MRI brain were both negative, without any signs of ventriculomegaly, while EEG revealed significant slowing without evidence of seizures. Psychiatry and Neurology recommended discontinuation of the patient''s home medications except ...
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