Perioperative management of lithium in the patient undergoing pituitary surgery: a case report.
Richards, Emma ; Pankhania, Miran ; Thomas, Charlotte ; Jolly, Karan ; Ayuk, John ; Ahmed, Shahzada
Richards, Emma
Pankhania, Miran
Thomas, Charlotte
Jolly, Karan
Ayuk, John
Ahmed, Shahzada
Abstract
Lithium is a psychotropic drug used primarily in the treatment of bipolar disorder. It is renally excreted and characteristically causes nephrogenic diabetes insipidus as an adverse drug reaction. Lithium also requires serum level monitoring as there is a narrow therapeutic window and untreated toxicity can result in neurological sequelae including drowsiness, coma, seizures, and ultimately death. We present the case of a 65-year old man admitted for pituitary surgery complicated by post-operative difficult fluid management and subsequent lithium toxicity. We highlight this rare situation and the need to be vigilant in the peri-operative period with any patients on lithium who undergo pituitary surgery.
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Date
2022-05-08
Type
Article
Subject
Neurology, Surgery, Patients. Primary care. Medical profession. Forensic medicine, Ear, Nose & Throat
Collections
Citation
Richards E, Pankhania M, Thomas C, Jolly K, Ayuk J, Ahmed S. Perioperative management of lithium in the patient undergoing pituitary surgery: a case report. Br J Neurosurg. 2024 Aug;38(4):1042-1044. doi: 10.1080/02688697.2021.2010651. Epub 2022 May 8.
Journal / Source Title
British Journal of Neurosurgery
DOI
10.1080/02688697.2021.2010651
PMID
35531871
Publisher
Taylor & Francis
Publisher’s URL
https://www.tandfonline.com/journals/ibjn20
