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We describe a case of acute lithium intoxication followed by progressive cerebellar atrophy and permanent cerebellar dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>Five years ago, a previously healthy 38-year-old man developed a clinical syndrome consistent with neuroleptic malignant syndrome (NMS)-like syndrome in the setting of acute lithium and quetiapine toxicity. On admission, the serum lithium concentration was 4.07\u00a0mmol\/L and the cerebrospinal fluid lithium concentration was 2.45\u00a0mmol\/L. Continuous renal replacement therapy (CRRT) was initiated, and cerebrospinal fluid lavage was also performed as documented in the outside hospital records. Serum lithium levels subsequently decreased to below 0.2\u00a0mmol\/L. After treatment, consciousness improved. However, he developed a persistent cerebellar syndrome, characterized by ataxia, gait instability, and dysarthria. Brain magnetic resonance imaging one year later revealed cerebellar atrophy. Over five years of follow-up, severe ataxia persisted, and serial MRI showed progressive isolated cerebellar atrophy without supratentorial structural abnormalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case suggests that severe acute lithium toxicity may be associated with progressive cerebellar degeneration, even after normalization of serum lithium levels. Clinicians should consider long-term follow-up for neurological sequelae in individuals suffering from acute lithium intoxication.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12883-026-04788-7","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T06:45:22Z","timestamp":1773038722000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A case report of persistent cerebellar dysfunction following acute lithium toxicity"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4471-4437","authenticated-orcid":false,"given":"Jiabei","family":"Nie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1308-8171","authenticated-orcid":false,"given":"Qing","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1283-6120","authenticated-orcid":false,"given":"Yiming","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaomeng","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1779-6554","authenticated-orcid":false,"given":"Yuyan","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"issue":"3","key":"4788_CR1","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1007\/s11845-011-0712-6","volume":"180","author":"U Dennison","year":"2011","unstructured":"Dennison U, Clarkson M, O\u2019Mullane J, Cassidy EM. 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