Dear Dr. Phelps,

Thank you for this site, actually my mother was under lithium toxicity, it caused her acute lenar failure and respiratory failues in addition she entered a coma for 3 weeks then wake up, all the failures were recovered, but she has problems with muscles, her hands respnded to the occupational therapy but her legs r less responding, the legs move in a weak way and they cause pain. my question is muscles problems can be recovered or it's something permenant, also I'd like to know about the neuro damage may be caused by this kind of toxicity

 Thank You in advance,
 Ruby
 

Dear Ruby -- 
Your question led to a search of the current writing about this subject.  What do we know about the long-term effects of an episode of lithium toxicity? Unfortunately, without seeing your mother's movement problems, I can't be at all certain that what she has is the same as what I hear described in a recent review of this issue. In other words, I could easily give you inaccurate information, since I don't know exactly what is going on for her at this point.  I definitely wouldn't want to say her "prognosis", her estimated future course, is bad--if I could possibly be wrong. Perhaps the safest thing to do would be to ask your local librarian to help you get a copy of the article I've linked below, and then hand that to her doctors.  Ask them if they think the article applies to her.   

So be careful.  This article might not apply to your mother's case.  But to provide at least some evidence-based answer to your question, I'd refer you to a recent review of this subject.^Adityanjee  The authors conclude that some of the problems they see in patients who have had lithium toxicity can be very long-lasting, possibly permanent, particularly with muscle control systems (the "cerebellum"). I hope that proves to be wrong in your mother's case. 

Dr. Phelps
 

May, 2005