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Acute Thyrotoxic Bulbar Myopathy with Encephalopathic Behaviour : An Uncommon Complication of Hyperthyroidism
Joint Authors
Boddu, Neeraja J.
Straub, Karl David
Badireddi, Sridhar
Jagana, Rajani
Schwankhaus, John
Source
Issue
Vol. 2013, Issue 2013 (31 Dec. 2013), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2013-06-09
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
Objective.
Acute thyrotoxic bulbar palsy is rare, severe, and rapidly progressive.
We describe a case of thyrotoxicosis with bulbar palsy, encephalopathy, and pyramidal tract dysfunction.
Case Report.
64-year-old white male with toxic multinodular goiter presented with rapid atrial fibrillation.
He had mild tremor, normal cranial nerve examination, 4/5 strength in all extremities, normal reflexes, and down going plantars.
TSH was low at 0.09 (normal: 0.34–5.6 uIU/mL), and free T4 was high at 5.22 (normal: 0.47–1.41 ng/dL).
Despite optimal AV nodal blockade, he had persistent rapid atrial fibrillation.
He later developed cervical dystonia, rigidity, clonus, dysarthria, dysphagia, vocal cord palsy, and absent gag reflex.
Thyroid storm was suspected.
Neuroimaging and cerebrospinal fluid cultures were nondiagnostic.
Acetylcholine receptor antibodies were negative.
Swallow ability was impaired with heavy secretions.
Remarkable improvement in symptoms was noted after initiation of treatment for thyroid storm.
Conclusion.
Pyramidal tract symptoms and bulbar palsy may occur with thyrotoxicosis.
Cranial nerve involvement and encephalopathy raise a question of primary brain mechanism causing bulbar palsy.
This is reversible with prompt treatment of thyroid storm.
American Psychological Association (APA)
Boddu, Neeraja J.& Badireddi, Sridhar& Straub, Karl David& Schwankhaus, John& Jagana, Rajani. 2013. Acute Thyrotoxic Bulbar Myopathy with Encephalopathic Behaviour : An Uncommon Complication of Hyperthyroidism. Case Reports in Endocrinology،Vol. 2013, no. 2013, pp.1-4.
https://search.emarefa.net/detail/BIM-466605
Modern Language Association (MLA)
Boddu, Neeraja J.…[et al.]. Acute Thyrotoxic Bulbar Myopathy with Encephalopathic Behaviour : An Uncommon Complication of Hyperthyroidism. Case Reports in Endocrinology No. 2013 (2013), pp.1-4.
https://search.emarefa.net/detail/BIM-466605
American Medical Association (AMA)
Boddu, Neeraja J.& Badireddi, Sridhar& Straub, Karl David& Schwankhaus, John& Jagana, Rajani. Acute Thyrotoxic Bulbar Myopathy with Encephalopathic Behaviour : An Uncommon Complication of Hyperthyroidism. Case Reports in Endocrinology. 2013. Vol. 2013, no. 2013, pp.1-4.
https://search.emarefa.net/detail/BIM-466605
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-466605