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. 2026 Feb 1.
doi: 10.2169/internalmedicine.6327-25. Online ahead of print.

Cytotoxic Lesion of the Corpus Callosum in a Patient with Acute-on-Chronic Lithium Toxicity: A Case Report

Takeshi Miura  1 , Teruki Kuroshita  2 , Yosui Higuchi  1 , Minori Ohno  1 , Ayano Notsuyu  1 , Takuya Fushino  1 , Takahiro Ono  1 , Natsumi Tomisawa  1 , Keishun Boku  1 , Yuki Enomoto  1 , Yoshiaki Inoue  1
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Free article

Cytotoxic Lesion of the Corpus Callosum in a Patient with Acute-on-Chronic Lithium Toxicity: A Case Report

Takeshi Miura et al. Intern Med. .
Free article

Abstract

A 30-year-old woman with history of bipolar disorder presented to the emergency department with impaired consciousness and myoclonus following regular lithium treatment. Brain magnetic resonance imaging revealed a hyperintense lesion in the splenium of the corpus callosum, consistent with cytotoxic lesions of the corpus callosum (CLOCCs). Serum lithium levels were markedly elevated (3.54 mmol/L), and acute-on-chronic lithium toxicity was diagnosed. Hemodialysis and supportive care resulted in clinical and radiological recovery. This case highlights that CLOCCs may serve as important neuroimaging evidence of lithium toxicity and may support an early diagnosis and treatment, especially in patients with long-term lithium use.

Keywords: brain; case report; corpus callosum; lithium toxicity; magnetic resonance imaging; renal dialysis.

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