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<p>A 31-year-old male with bipolar disorder on long-term lithium therapy presented to our emergency department with cerebellar and extrapyramidal signs, accompanied by fever and elevated creatine kinase levels. Cerebellar symptoms persisted for one year during follow-up. The patient was diag- nosed with Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (SILENT) and concomitant neuroleptic malignant syndrome (NMS). This case highlights the rare coexistence of these serious complications, underscores the diagnostic and therapeutic challenges, and contributes to the litera- ture on clinical management.</p>

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Co-occurrence of Neuroleptic Malignant Syndrome and Silent Syndrome in a Patient With Bipolar Disorder: Clinical Challenges and Long-term Neurological Sequelae

  • 期刊论文

  • 发表日期：

    2026年1月27日

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  • Buse Ceyran,
  • Efruz Pirdogan Aydin,
  • Burce Yucel,
  • Derya Selcuk Demirelli

摘要

A 31-year-old male with bipolar disorder on long-term lithium therapy presented to our emergency department with cerebellar and extrapyramidal signs, accompanied by fever and elevated creatine kinase levels. Cerebellar symptoms persisted for one year during follow-up. The patient was diag- nosed with Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (SILENT) and concomitant neuroleptic malignant syndrome (NMS). This case highlights the rare coexistence of these serious complications, underscores the diagnostic and therapeutic challenges, and contributes to the litera- ture on clinical management.