title: Reversible posterior leukoencephalopathy syndrome after withdrawal of antipsychotic medication in the context of lithium intoxication.
abstract: OBJECTIVE
  To report a case of reversible posterior leukoencephalopathy syndrome (RPLS) after withdrawal of antipsychotic medication in a patient with acute lithium intoxication.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  A patient with schizoaffective disorder was admitted with lithium intoxication, rhabdomyolysis and acute renal failure. After withdrawal of psychotropic medication, she developed a significant increase in blood pressure - though to moderately hypertensive levels - and prolonged disturbance of consciousness with profound agitation. MRI revealed RPLS. Resumption of antipsychotic treatment resulted in significant drop of blood pressure and improvement.
  
  
  CONCLUSIONS
  Acute withdrawal of antipsychotic medication may lead to rebound hypertension and development of RPLS, especially in the presence of lithium intoxication and renal dysfunction.
authors: Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: loens.sebastian@mh-hannover.de.
authors: Sebastian
authors: S
authors: Loens
authors: Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors: Josef
authors: J
authors: Conzen
authors: Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors: Gabriel Simon
authors: GS
authors: Welte
authors: Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors: Nicole
authors: N
authors: Scharn
authors: Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors: Christoph
authors: C
authors: Schrader
authors: Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors: Karin
authors: K
authors: Weissenborn
mesh_terms: D018692:Antimanic Agents / Q000633:toxicity*; D014150:Antipsychotic Agents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D018020:Lithium Compounds / Q000633:toxicity*; D008875:Middle Aged; D054038:Posterior Leukoencephalopathy Syndrome / Q000139:chemically induced*; D011618:Psychotic Disorders / Q000188:drug therapy*
chemical_list: D018692:Antimanic Agents; D014150:Antipsychotic Agents; D018020:Lithium Compounds
keywords: Antipsychotics; Lithium intoxication; PRES; RPLS; Reversible posterior leukoencephalopathy syndrome; acute renal failure