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[Subacute motor neuropathy induced by T3 hyperthyroidism].

Dominique Caparros-Lefebvre¹, Sonia Benabdallah, Xavier Bertagna

¹Service de Neurologie, CHU de la Guadeloupe. caparros-d@chu-caen.fr

Annales De Medecine Interne

|January 21, 2004

Summary

Hyperthyroidism can cause subacute motor neuropathy, a rare complication. This case shows that thyroidectomy can effectively treat this neurological condition, improving symptoms.

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Area of Science:

Neurology
Endocrinology

Background:

Subacute motor neuropathy involving bulbar nerves is an uncommon complication of hyperthyroidism.
Clinical and neurophysiologic follow-up of such patients is rarely reported.

Observation:

A 41-year-old patient presented with respiratory failure, diffuse amyotrophy, facial paresis, and fasciculations.
Electromyography revealed an axonal neuropathy with predominant motor involvement.
The patient had goiter with hypervascularization and pure T3 hyperthyroidism.

Findings:

Antithyroid drugs (carbimazole, propylthiouracil) induced vasculitis.
Total thyroidectomy led to rapid improvement in general status, motor deficit, amyotrophy, and pyramidal syndrome.
Electromyographic abnormalities significantly improved within 3 months post-surgery.

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Implications:

Hyperthyroidism can cause treatable motor axonal neuropathy.
Radical surgery (thyroidectomy) offers a curative option for this rare neurological complication.
This case highlights the importance of considering thyroid dysfunction in unexplained motor neuropathies.