Analyse de la documentation sur les séquelles neurologiques permanentes secondaires à une intoxication aiguë au lithium.
Méthode:
Soixante-six articles en langue française et anglaise ont été passés en revue de 1968 à 1997 en utilisant Medline.
Résultats:
Cinquante-neuf cas ont été examinés dans la documentation et classifiés selon trois registres: le premier concerne les cas d'intoxication au lithium sans neuroleptique ayant entraîné un syndrome cérébelleux; le deuxième regroupe les cas où le lithium a été associé à un neuroleptique; et le troisième groupe présente des cas de séquelles neurologiques diverses, qu 'il y ait eu ou non association avec un neuroleptique.
Conclusions:
Le lithium présente une toxicité intrinsèque pour le système nerveux central et un tropisme particulier pour le cervelet. L'association avec des neuroleptiques semble augmenter sa toxicité ainsi que certains facteurs associés dont les états infectieux et la correction rapide de la lithémie. Nous discutons des mécanismes physiopathologiques actuellement invoqués pour expliquer la neurotoxicité du lithium.
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