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What are the neurologic features of hyperthyroidism?
Thyrotoxicosis may manifest with reversible behavioral and cognitive changes, including emotional lability, euphoria, irritability, mania, and psychosis. Delirium may be observed as a manifestation of thyroid storm.
Apathetic hyperthyroidism may appear as fatigue, with symptoms suggesting depression or dementia.
Other features of thyrotoxicosis are tremor of the hands, eyelids, or tongue, as well as chorea, spasticity (sometimes with clonus and Babinski’s signs), thyrotoxic periodic paralysis, and myopathy.
Neurologic problems usually resolve after treatment of the underlying thyrotoxicosis, but thyroid ophthalmopathy often requires surgical orbital decompression.
Additionally, bulbar palsies and motor weakness may not recover following correction of hyperthyroidism secondary to coexistence of other dysimmune disease, such as acute myasthenia gravis.
Sources
- Mathew V, Misgar RA, Ghosh S, Mukhopadhyay P, Roychowdhury P, Pandit K, et al.: Myxedema coma: a new look into an old crisis. J Thyroid Res Article ID 493462, 2011.
- Abend WK, Tyler HR: Thyroid disease and the nervous system. In Aminoff M (ed): Neurology and general medicine. New York, Churchill-Livingstone, pp 333-348, 1995.
