When the new year began, this was my situation:
BALANCE
When I was discharged from the hospital:
- I couldn’t sit upright without falling to the sides.
- I couldn’t stand on my own.
- My torso trembled violently.
- My head constantly shook side to side, back and forth.
Now:
- I can sit upright.
- My head tremor has lessened.
- I can stand independently and walk on my own (though I still lose balance).
- I have significantly improved control over my torso tremor — I still tilt to the sides sometimes, but I recover more quickly.
- I used to struggle to take a full step with my right leg; now both legs step more evenly.
- Walking on soft surfaces (balance pads, grass) is still challenging, but there is some improvement.
COORDINATION
My hand-eye coordination was almost non-existent.
For example, I couldn’t catch a ball if it was thrown to me.
Now:
- I can sometimes catch a ball, although I still miss it occasionally.
- I can type on a keyboard (hitting the correct keys).
- I can text on my phone (accurately hitting the letters).
- Using both hands at the same time is still difficult.
- Clapping is hard, but if I do it slowly, I can manage.
SPEECH
While in the hospital, I couldn't speak at all.
When I was discharged, only a few words would come out — my voice sounded like a baby’s and was very faint.
Now:
- I can pronounce words correctly.
- My voice is deeper. Sometimes I hear glimpses of my real voice.
- My voice sounds louder and stronger.
- I have started using more natural intonation and emphasis.
- I speak faster now, though I am still dysarthric.
MY HANDS
My biggest struggle was — and still is — with my dominant hand, my right.
When I first came home, I couldn’t feed myself, brush my teeth, or even hold a cup. Writing was completely impossible. Showering alone was out of the question.
Now:
- Despite persistent tremor, I can feed myself, brush my teeth, and hold a cup.
- I can use my phone and laptop.
- I can write — badly and slowly, but I can.
- I can do some painting and coloring — again, badly, but I can.
- Doing makeup is still very difficult; my hands shake when brought to my face.
- Stirring soup or similar tasks remain tough.
In short: my hands have shown the least improvement, despite all my efforts.
When lithium was discontinued, I saw noticeable improvement in both my balance and speech within the first month.
However, because my mood stabilizer changed (I started taking Depakine), I also began to experience increased appetite and emotional detachment. In January alone, I gained 3 kilos — thanks to endless chocolate.
Then, my physiotherapist changed, and I had to adapt to a new program. I was training six days a week, two hours a day — it was exhausting.
Sometimes I could literally feel my brain burning.
I kept going with stable exercises, but my progress was still painfully slow.
In June, I finally dared to walk outside with a cane.
But one day, as I was leaving a supermarket, an automatic door closed on me, and I fell badly.
I split open my forehead.
After that, I developed a severe fear of walking outdoors.
I stayed at home for months, terrified to walk again.
It crushed my morale.
I felt like I wasn’t healing at all.
In desperation, I decided to see one more doctor — a very famous and highly respected neurologist.
He quickly dismissed previous suggestions about FND (Functional Neurological Disorder) and said:
"Your problem is not psychological. You have cerebellar dysfunction."
He reviewed my medical records:
- My lithium level during the initial illness was 1.19.
- Since I hadn’t lost consciousness, he believed it was consistent with lithium intoxication.
- Lithium toxicity combined with high fever could cause ataxia — and it was even written in the drug’s prospectus as a known side effect.
Researching lithium toxicity shocked me.
It explained everything I had gone through.
The name of the condition?
SILENT syndrome — Syndrome of Irreversible Lithium-Effectuated Neurotoxicity.
I had been diagnosed with bipolar disorder in 2015 and had started lithium then.
Now, looking back, I curse that day.
Toward the end of the year, I had the chance to travel to Dubai.
I consulted another neurologist there to get a second opinion.
He reviewed my MRI scans and bloodwork — and he was puzzled:
"At your age, such severe ataxia shouldn’t happen."
He suspected either vitamin E deficiency or copper excess, because both can cause ataxia.
But tests showed neither vitamin E deficiency nor copper excess.
It was all because of lithium.
*SILENT syndrome (Syndrome of Irreversible Lithium-Effectuated Neurotoxicity) is a rare condition where lithium treatment causes permanent neurological damage even after the drug is stopped.
Symptoms often include:
- Tremor
- Ataxia (loss of balance and coordination)
- Dysarthria (speech difficulties)
- Cognitive impairment
- Visual disturbances
It typically occurs after lithium toxicity, and symptoms can persist even after blood lithium levels return to normal.
