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The Perfusion Pattern in a Patient With Lithium Intoxication Mimicking Creutzfeldt-Jakob Disease
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Lithium intoxication exhibits a wide range of neurologic manifestations includingtremor, ataxia, nystagmus, dysarthria, and parkinsonian symptoms. When lithiumintoxication manifests as cognitive decline, myoclonus, and tremor, it can bedifficult to distinguish from Creutzfeldt-Jakob disease (CJD) because diagnosisof possible CJD can be made if the patient has 2 or more of following clinicalfeatures with a duration less than 2 years: dementia, visual or cerebellardysfunction, pyramidal or extrapyramidal signs, and akinetic mutism.After its first description by Smith and Kocen,a few cases of lithium-induced encephalopathymimicking CJD have been reported (eg, Kikyo et al). Here we report a patient who was treated withlithium and developed subacute myoclonus and cognitive dysfunction, with changesin perfusion pattern identified using brain single-photon emission computedtomography (SPECT).