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Thyrotoxicosis presenting with headache.

J Stone1, A Foulkes, K Adamson

  • 1School of Molecular and Clinical Medicine, University of Edinburgh, Western General Hospital, Edinburgh, UK. jon.stone@ed.ac.uk

Cephalalgia : an International Journal of Headache
|June 30, 2007
PubMed
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Severe headaches can signal thyrotoxicosis (overactive thyroid). This study highlights three neurology cases where this thyroid condition was initially missed. Other hyperthyroid signs are usually present when headache is a primary symptom.

Area of Science:

  • Neurology
  • Endocrinology

Background:

  • Thyrotoxicosis, a condition of thyroid hormone excess, can present with diverse symptoms.
  • Headache is a recognized but often overlooked symptom of thyrotoxicosis.

Observation:

  • Three patients presented to a neurology service with acute headache over one year.
  • Two patients had a history of migraine, complicating the initial assessment.
  • Thyrotoxicosis was not diagnosed in primary care despite subtle clinical indicators.

Findings:

  • Severe headache can be a prominent initial presentation of thyrotoxicosis.
  • The diagnosis of thyrotoxicosis was missed in primary care in these instances.
  • Concurrent hyperthyroid signs were present in all cases upon closer examination.

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Implications:

  • Clinicians should consider thyrotoxicosis in patients presenting with severe headache, especially if other hyperthyroid features are present.
  • This case series offers reassurance that accompanying signs of hyperthyroidism are typically observable.
  • Improved diagnostic awareness of thyrotoxicosis presenting as headache may reduce diagnostic delays.