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Neuromuscular findings in thyroid dysfunction: a prospective clinical and electrodiagnostic study.

R F Duyff1, J Van den Bosch, D M Laman

  • 1Department of Neurology, St Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE Amsterdam, The Netherlands.

Journal of Neurology, Neurosurgery, and Psychiatry
|May 16, 2000
PubMed
Summary

Neuromuscular symptoms are common in newly diagnosed thyroid dysfunction. While hyperthyroid weakness resolves quickly with treatment, hypothyroid weakness may indicate a more persistent myopathy.

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Area of Science:

  • Endocrinology
  • Neurology
  • Internal Medicine

Background:

  • Thyroid dysfunction, including hypothyroidism and hyperthyroidism, can manifest with various systemic symptoms.
  • Neuromuscular involvement is a recognized but often underdiagnosed complication of thyroid disorders.

Purpose of the Study:

  • To investigate the prevalence and characteristics of neuromuscular signs and symptoms in patients with newly diagnosed hypothyroidism and hyperthyroidism.
  • To assess the impact of treatment on these neuromuscular manifestations.

Main Methods:

  • A prospective cohort study involving adult patients with newly diagnosed thyroid dysfunction.
  • Clinical evaluation using hand-held dynamometry and electrodiagnosis.
  • Monitoring of clinical features, sensory signs, and biochemical data during treatment.

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Main Results:

  • Hypothyroid patients frequently reported neuromuscular complaints (79%), weakness (38%), sensorimotor axonal neuropathy (42%), and carpal tunnel syndrome (29%).
  • Hyperthyroid patients experienced neuromuscular symptoms (67%) and weakness (62%), with weakness correlating with FT4 levels and resolving rapidly within 3.6 months.
  • Sensorimotor axonal neuropathy was observed in 42% of hypothyroid and 19% of hyperthyroid patients, while carpal tunnel syndrome was only seen in hypothyroid patients.

Conclusions:

  • Neuromuscular symptoms and signs are prevalent in newly diagnosed thyroid dysfunction.
  • Hyperthyroid weakness appears functional and resolves completely with treatment, whereas hypothyroid weakness may suggest a more persistent myopathic process.
  • Hand-held dynamometry is a valuable tool for detecting weakness and monitoring treatment efficacy in thyroid disease.