Symptom Management in Multiple Sclerosis

Abstract

Matters arising criteria for diagnosis could be the following:(1) onset with acute organic brain disease, (2) anamnestic and/or laboratory evidence of lithium over dosage prior to the onset of acute organic brain disease, (3) simulta- neous appearance of severe cerebellar signs and of mild peripheral neuropathy as con- sciousness recovers, (4) persistence of cere- bellar signs six months after poisoning and discontinuation of lithium therapy.This last point is supported by the evi- dence that substantial improvements of the neural deficits themselves cannot be expected after six months, though functional improvement may occur3 up to one year after poisoning."4As Dr Adityanjee remarks, non-nervous acute and chronic sequelae, such as renal and/or cardiac failure, Grave's disease and myopathies may complicate the clinical pic-1247 ture.4These sequelae may also be dramatic ever, the syndrome itself could be identified enough to point to some form of acute and related to lithium poisoning with a intoxication,' and/or persist to various higher degree of specificity.degrees of severity4: nevertheless, they seem to lack the specificity needed for a suspicion of lithium poisoning either in the acute or in the chronic phase.Dr Adityanjee claims that neurological References signs and symptoms may well follow chronic I Tesio L, Porta GL, Messa E. Cerebellar syn- lithium intoxication, too: however, he also drome in lithium poisoning: a case of partial recalls that usually they are much more vari-recovery.J Neurol Neurosurg Psychiatry ous and reversible than those following 1987;50:235.acute intoxication.Thus, I suppose he 2 Cohen WJ, Cohen NH.Lithium carbonate.would agree that the identification of a haloperidol, and irreversible brain damage.specific and irreversible syndrome in chronic