Reversible posterior leukoencephalopathy syndrome after withdrawal of antipsychotic medication in the context of lithium intoxication

General Hospital Psychiatry
Sebastian LoensKarin Weissenborn

Abstract

To report a case of reversible posterior leukoencephalopathy syndrome (RPLS) after withdrawal of antipsychotic medication in a patient with acute lithium intoxication. Case report. 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. Acute withdrawal of antipsychotic medication may lead to rebound hypertension and development of RPLS, especially in the presence of lithium intoxication and renal dysfunction.

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Citations

Mar 30, 2019·Molecular Neurobiology·Bérenger LargeauStephan Ehrmann

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