Acute autonomic and sensory neuropathy associated with elevated Epstein-Barr virus antibody titre.

Severe peripheral neuropathy due to lithium intoxication Sir: Central nervous system damage due to lithium intoxication is well known,' but evidence of peripheral nervous system damage is scanty.Three reports of indi- vidual cases have been made;'-3 in only one was the neuropathy severe, and all three cases recovered without apparent sequelae.We report a case of severe, per- sisting central and peripheral nervous system damage following lithium intoxication.A 31-year-old man with a history of manic-depressive psychosis had been main- tained on lithium carbonate 1500 mg/day.While working as a volunteer on an Israeli kibbutz, the dose was inadvertently increased to 1800 mg/day.He was admit- ted to a local hospital after the gradual onset of confusion, weakness, and tremul- ousness.Serum lithium level on admission was 3*63 mmol/l, and daily haemodialysis was instituted.However, he became com- atose after two days and required assisted ventilation.Nephrogenic diabetes insipidis was diagnosed and treated with frusemide and salt restriction.He regained con- sciousness 11 days after admission, but could obey only simple commands, was hardly able to speak, could swallow liquids only, and remained bedridden.Urinary