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Graves' disease complicating myelopathy.
1Spinal Cord Injury and Optometry Services, Veterans Administration Medical Center, Brockton, MA 02104.
Paraplegia
|August 1, 1992
Summary
Chronic myelopathy patients frequently exhibit exophthalmos and supraventricular arrhythmias. These conditions may be linked to residual effects of prior Graves' disease, suggesting a need for further investigation into thyroid-related complications.
Area of Science:
- Neurology
- Endocrinology
- Ophthalmology
Background:
- Chronic myelopathy is associated with observed exophthalmos, supraventricular arrhythmias, and myxedema.
- A survey was conducted to investigate these clinical observations in myelopathy patients.
Purpose of the Study:
- To document and explain the increased incidence of exophthalmos, supraventricular arrhythmias, and myxedema in patients with chronic myelopathy.
- To compare these findings with a control group.
Main Methods:
- Exophthalmometry using the Hertel instrument was performed on 77 male myelopathy patients and compared with controls.
- Electrocardiograms (EKGs) were reviewed for arrhythmias in myelopathy patients and controls.
- Thyroid function tests were conducted and compared with standard values.
Main Results:
- 12% of myelopathy patients showed abnormal ocular protrusion (exophthalmos), compared to none in controls (p < 0.001).
- Supraventricular arrhythmias were significantly more common in myelopathy patients than controls (p < 0.02).
- Hypothyroidism was found in 2.7% of tested myelopathy patients.
Conclusions:
- Exophthalmos, supraventricular arrhythmias, and myxedema are unusually prevalent in chronic myelopathy.
- Residual effects from preceding Graves' disease are proposed as a potential explanation for these findings.