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Lithium induced CJD symptoms in 67 yr old French man.

Kathy

Well-known member
This papers highlights the importance of understanding the CAUSE of symptoms. Stopping treatment with Lithium resulted in the ceasation of the CJD-like symptoms.

This puts forward an important question, "how many CJD victims (deceased/diagnosed) were being treated with Lithium?"

The Alberta company "TrueHope" manufactures a nutritional supplement called "Empower Plus" for treating people suffering from bi-polar disease. Users have successfully gone off Lithium and other drugs.

Rev Neurol (Paris). 2006 Nov;162(11):1118-21.

Lithium-induced encephalopathy mimicking Creutzfeldt-Jakob disease

Mouldi S, Le Rhun E, Gautier S, Devemy M, Destee A, Defebvre L. (article in French)

Service de Neurologie et Pathologie du Mouvement, EA 2683, Hopital Roger Salengro, rue du Professeur Emile Laine, CHRU, 59037 Lille Cedex.

Introduction. Creutzfeldt-Jakob disease (CJD) has a poor prognosis. Certain clinical presentations can be suggestive yet mimic a curable disease. Observation. In the present study, we report the case of a 67-year-old man with a one-month history of progressive dementia, with myoclonic jerks and cerebellar syndrome suggesting a diagnosis of Creutzfeldt-Jakob encephalopathy. He had been treated for 9 years with lithium for a bipolar disorder. The results of the different investigations and the favorable course after discontinuation of lithium were in favor of the diagnosis of drug-induced Creutzfeldt-Jakob syndrome. CONCLUSION: This case illustrates the importance for researching a curable etiology in presence of clinical features suggesting a CJD.

PMID: 17086148
 

Kathy

Well-known member
Apparently, there is a known history of CJD like symptoms occurring in patients being treated with Lithium, antidepressants and bismuth.

Rinsho Shinkeigaku. 1997 Apr;37(4):338-40.

Creutzfeldt-Jakob like syndrome due to lithium intoxication--a case report[Article in Japanese]
Takahashi M, Hashimoto S, Suenaga T, Nakamura M, Takahashi K.
Department of Neurology, Tenri Hospital.

A woman with mania who had been treated with lithium carbonate since 69 years of age presented mild tremulousness of both hands at the age of 76 years. She subsequently developed dysphagia, dysarthria, unsteady gait and progressive deterioration of the higher cortical function over 1.5 months. Her tremulousness deteriorated until it resembled myoclonus. EEG showed periodic sharp wave complexes appearing predominantly over the bilateral parieto-occipital areas. Although the EEG abnormality was not identical with that usually observed in the fully developed stage of Creutzfeldt-Jakob disease (CJD), it was reminiscent of that seen in the early stage of CJD. Thus, her clinical symptoms and signs were considered to resemble those of CJD. The plasma concentration of lithium, however, was found to be over the therapeutic range. Reduction of the dose of lithium carbonate almost completely resolved her symptoms within 3 weeks. Consequently, her clinical condition was considered lithium intoxication. Antidepressant and bismuth as well as lithium have been reported to induce a Creutzfeldt-Jakob like syndrome. Awareness of drug-induced Creutzfeldt-Jakob like syndrome is clinically important because of its excellent prognosis as opposed to the ominous prognosis of CJD.

PMID: 9248346

Clin Neuropharmacol. 1996 Aug;19(4):356-9.

Lithium-induced Creutzfeldt-Jakob syndrome.
Casanova B, de Entrambasaguas M, Perla C, Gomez-Siurana E, Beneto A, Burguera JA.
Department of Neurology, Hospital Universitari La Fe, Valencia, Spain.

a 67-year-old man with bipolar disorder developed a Creutzfeldt-Jakob like syndrome during lithium carbonate treatment. Lithium serum level was within the therapeutic range. Complete clinical-electroencephalographic recovery was achieved after lithium therapy was discontinued. Several cases of lithium-induced Creutzfeldt-Jakob syndrome have been reported to date; all of them were elderly patients and a half had "therapeutic" lithium serum levels. Patients in this age group receiving antimanic maintenance treatment should keep lithium serum levels as low as possible. Lithium neurotoxicity should be considered in Creutzfeldt-Jakob disease differential diagnosis, serial electroencephalograms being the most valuable.

PMID: 8828999

J
Psychiatry Neurosci. 1992 Sep;17(3):103-5.

Drug-induced Creutzfeldt-Jakob like syndrome.

Finelli PF.
Department of Neurology, Hahnemann University, Philadelphia, Pennsylvania.

A patient with progressive neurological deterioration characterized by cognitive impairment, myoclonus, Parkinson's syndrome, an abnormal electroencephalogram and fasciculations was considered for brain biopsy for suspected Creutzfeldt-Jakob disease. Complete clinical recovery followed discontinuation of lithium and nortriptyline. Awareness of this unusual drug-induced Creutzfeldt-Jakob like syndrome can avoid costly, invasive and unnecessary investigative procedures.

PMID: 1390620


J Neurol Neurosurg Psychiatry. 1988 Jan;51(1):120-3.

A Creutzfeldt-Jakob like syndrome due to lithium toxicity.

Smith SJ, Kocen RS.
National Hospital for Nervous Diseases, Queen Square, London, UK.

Two patients with lithium toxicity presented with a neurological syndrome suggesting a diagnosis of Creutzfeldt-Jakob disease. In both cases, the initial EEG was consistent with this diagnosis. Neither patient had permanent neurological sequelae and the EEG returned to normal. A careful drug history should be taken in any patient who presents with a rapidly progressive dementia even when the EEG supports a diagnosis of Creutzfeldt-Jakob disease.

PMID: 3127546
 
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