Background: Lithium has been used as a mood stabilizer for over a century, it is still the first-line agent for bipolar disorder (1, 2). A Large proportion of patients on chronic lithium therapy experience at least one episode of toxicity during treatment given its narrow therapeutic window (3). Case Presentation: This is a case report of a 50-year-old female with bipolar affective disorder who developed the syndrome of irreversible lithium effectuated neurotoxicity (SILENT). The case presentation covers the clinical symptoms and signs of SILENT causing functional impairment which effects their mobility and activities of daily living. Conclusion: Given its rare presentation, it is important for clinicians to be aware of this syndrome and its devastating effects. Early rehabilitation measures may help with achieving some functional independence but would assist with community reintegration and quality of life, long term.