SANP Swiss Archives of Neurology, Psychiatry and Psychotherapy 2297-7007 2297-6981 EMH Schweizerischer Ärzteverlag AG Farnsburgerstrasse 8 CH-4132 Muttenz 03150 10.4414/sanp.2020.03150 Case report Neurotoxicology Posterior reversible encephalopathy syndrome (PRES) in a patient with long-term lithium intake and non-toxic serum lithium levels Spyth Jakob jakob.spyth@zuerich.ch Resident | Psychiatrische Poliklinik Zürich | Walchestrasse 31 | Zürich | 8021 | SWITZERLAND Schweigkofler Beatrix Safavi Seyed Mehdi Engel Antoinette Briner David 06 11 2020 171 06 0 0 Copyright: EMH Schweizerischer Ärzteverlag AG 2020 EMH Schweizerischer Ärzteverlag AG "Swiss Archives of Neurology, Psychiatry and Psychotherapy" is an open access publication of EMH published in accordance with the terms of the Creative Commons licence attribution - NonCommercial - NoDerivatives 4.0 International. You are free to share, copy and redistribute the material in any medium or format under the following terms: Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. NonCommercial — You may not use the material for commercial purposes. NoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material. "Non-commercial" means not primarily intended for or directed towards commercial advantage or monetary compensation. The incorporation of publications in commercial products, the use of publications to advertise for commercial products or services and any other usage that directly or indirectly pursues commercial interests is subject to the express previous consent of the publishing house as part of a written agreement. Please send us your request in writing. Exact indication of the publication from which you would like to reproduce material and detailed information about its intended use help to facilitate and expedite request processing.

Objective: We report one case of posterior reversible encephalopathy syndrome (PRES), in which lithium may played a role in the development and the maintaining of the above mentioned syndrome. Methods: Case report. Results: A patient with stable schizoaffective disorder under long-time prescription of lithium was admitted to a medical hospital after falling in her home. For two weeks prior to the admission, she has had a short history of minor infections. Two days after the admission, she developed an encephalopathy, which was diagnosed as PRES radiographically. Lithium was identified as a possible contributer to the development of PRES and consequently discontinued, even though when tested, lithium-serum-levels never exceeded the predefined norm. After discontinuation of lithium, the patient recovered under further treatment. Conclusion: The course of the case and research of the current literature suggest, that lithium may be seen as a risk factor in the development of PRES.