Polyneuropathy in Lithium Intoxication: A Case Report

鋰中毒引起之多發性神經病變︰一病例報告

洪怡珣(Yi-Shiung Horng) ； 張權維(Chein-Wei Chang) ； 連倚南(I-Nan Lien)

《中華民國復健醫學會雜誌》 20期 (1992/12) Pp. 191-197

https://doi.org/10.6315/JRMA.199212.0011

摘要

鋰鹽中毒可引起神經、泌尿，消化、內分泌及心臟血管系統等多方面之功能病變，其中以中樞及周邊神經系統病變最為嚴重及罕見。我們報告一個四十九歲男性躁鬱症病人於接受鋰鹽治療五年後，因鋰鹽中毒導致重度小腦功能障礙及輕度周邊神經病變。臨床上病人呈現意識障礙、嘔吐、運動失調及不自主運動等症狀，停藥後兩天測得之鋰鹽血中濃度為1.80meq/l。神經傳導速度檢查顯示於腓神經及脛神經之運動神經傳導速度有輕度減慢，以及複合運動電位波之振幅下降等現象。肌電圖顯示於檢查之伸趾短肌及外展小指肌有自發性顫波及多相波、腓腸肌神經病理切片檢查證實有神經軸突退化及髓鞘減少等現象。經由停藥及復健治療，病人的平衡、運動及感筧功能逐漸有進步，二個月後，病人可藉助行器自己行走。

並列摘要

Intoxication of lithium carbonate may present as a multiple systematic dysfunction, but central and peripheral nervous involvement is rare and more troublesome. In the past, there was only one case of lithium intoxication with polyneuroparhy reported by Chang et al in Taiwan. We report here an additional 49 year-old man with manic-depressive psychosis. He received lithium carbonate medication treatment for 5 years and developed a severe cerebellar dysfunction and a mild sensori-motor polyneuropathy. Blood lithium level was 1.80meq/l two days after quitting lithium. Nerve conduction velocity studied, electromyography and sural nerve biopsy confirmed the peripheral neuropathy with marked evidence of axonal degeneration. The patient got improvement after quitting the medication and receiving rehabilitation therapy.

並列關鍵字

lithium intoxication ； polyneuroparhy