Publicación Oficial de la Sociedad Ecuatoriana de Neurología, de la Liga Ecuatoriana Contra la Epilepsia y de la Sociedad Iberoamericana de Enfermedad Cerebrovascular

conciencia

 

Alteración del estado de conciencia secundario a intoxicación por litio. Altered state of consciousness secondary to lithium intoxication

Introduction: Lithium is a pharmacological molecule that is commonly used in patients with bipolar affective disorder. Due to its chemical similarity to sodium, alterations in the latter have a direct effect on its plasma concentrations. Among the complications that can occur are nephrogenic diabetes insipidus, thyroid dysfunction, and some central nervous system defects such as nystagmus, ataxia, tremor, fasciculations, seizures, and coma.

Objective: To present the case of a patient with a syndrome of altered state of consciousness secondary to lithium poisoning coincide.

Clinical case: 61-year-old woman with a history of bipolar affective disorder who presented the syndrome of altered state of consciousness associated with lithium poisoning, for which reason the drug was withdrawn and hemodialysis sessions were carried out, obtaining an adequate response. with improvement of renal function and normalization of serum lithium values (0.76 mmol / L).

Conclusions: Lithium may involve alterations at the renal level that are associated with modifications in serum electrolytes. This can facilitate the appearance of neurological symptoms or symptoms, as evidence in the present case.

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Síndrome de Locked-In: Reporte de Caso y Revisión de Literatura. Locked-In Syndrome: Case Report And Review Of Literature.

Locked-In Syndrome, also known as Enclaustration, Deseferentization, or Enclosure Syndrome, was first defined in 1966 by Plum and Posner. Causes can be grouped into vascular and non-vascular, the former being the most frequent. Clinically this syndrome is characterized by consciousness and the state of watch conserved, but there is quadriplegia, anartria, dysphagia and difficulty to coordinate the ventilatory mechanics, representing pulmonary complications the main cause of death. In most cases, the patient retains vertical eye mobility, so the only method of communication is through eye blinking and vertical eye movements. Next, a case presentation and review of the literature with the most relevant pathophysiological, clinical, diagnostic and therapeutic aspects is done.

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