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Generalized convulsions with diffuse spike and wave bursts emerging with Graves' disease
1Division of Pediatrics and Child Neurology, Department of Brain and Nerve Science, Oita University Faculty of Medicine, Yufushi, Oita, Japan. tmaeda@med.oita-u.ac.jp
Neuropediatrics
|January 20, 2007
Summary
Thyroid hormone can lower seizure threshold. This case study shows Graves' disease-associated seizures resolved with antithyroid treatment, normalizing EEG, suggesting hyperthyroidism can trigger epilepsy.
Area of Science:
- Neurology
- Endocrinology
Background:
- Thyroid hormones significantly influence neurological function, with excess levels potentially lowering the seizure threshold.
- Graves' disease, a common cause of hyperthyroidism, can present with diverse neurological symptoms.
Observation:
- A female patient with Graves' disease experienced generalized convulsions.
- Electroencephalography (EEG) revealed diffuse 2- to 2.5-Hz spike and wave (SW) bursts, particularly after hyperventilation, without absence seizures.
- Seizures were generalized tonic-clonic, occurring during sleep.
Findings:
- Thiamazole treatment normalized thyroid hormone levels (euthyroid state) and resolved convulsions.
- EEG abnormalities, including diffuse SW bursts, promptly normalized with antithyroid therapy.
- The clinico-electroencephalographic characteristics suggested a potential link between hyperthyroidism and idiopathic generalized epilepsy (IGE).
Implications:
- Hyperthyroidism may precipitate or exacerbate epilepsy, particularly IGE.
- Antithyroid pharmacotherapy alone can effectively manage epilepsy in patients with coexisting hyperthyroidism.
- This case highlights the importance of considering thyroid function in the evaluation of new-onset epilepsy.
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