Lithium toxicity can produce persistent and possibly permanent neurologic damage involving multiple areas of the nervous system, often including the cerebellum. Such cases, though rare, may continue to occur since lithium salts are widely used. In this report we describe the neurologic presentation, rehabilitation management, and outcome of treatment in such a patient. Her persistent neurologic syndrome was dominated by features of cerebellar dysfunction. Deficits in speech, swallowing, activities of daily living, transfers, and ambulation were identified and a rehabilitation program was implemented. Therapeutic rehabilitative techniques focused on compensatory mechanisms for ataxia and incoordination. Though her basic neurologic status did not change substantially, she did respond well to rehabilitative measures with significant functional gains and the patient was returned to her prior living arrangement.
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