A case of Parkinsonism due to lithium intoxication: treatment with Pramipexole.
We report the case of a 72-year-old woman with bipolar disorder treated with lithium for over a year, who suddenly developed disabling Parkinsonism, apparently after a gastroenteric infection. On hospital admission lithium plasma levels were 3.7 mmol/l. After lithium discontinuation, plasma levels decreased to 0.7 mmol/l, but without resolution of neurological symptoms. Biperidene and levodopa-benserazide did not ameliorate her extrapyramidal symptoms. Pramipexole 0.25 mg TID improved dramatically the Parkinsonism and all neurological symptoms resolved in a few days.
Dallocchio
Carlo
C
Divisione di Neurologia, Ospedale Civile di Voghera, ASL Pavia, Italy. mariagela_lodi@asl.pavia.it
Mazzarello
Paolo
P
D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D052160:Benzothiazoles; D018491:Dopamine Agonists / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008094:Lithium / Q000506:poisoning*; D020734:Parkinsonian Disorders / Q000139:chemically induced* / Q000188:drug therapy* / Q000503:physiopathology; D000077487:Pramipexole; D012720:Severity of Illness Index; D013844:Thiazoles / Q000627:therapeutic use*
D000978:Antiparkinson Agents; D052160:Benzothiazoles; D018491:Dopamine Agonists; D013844:Thiazoles; D000077487:Pramipexole; D008094:Lithium