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Thyrotoxicosis presenting as acute bulbar palsy.

Betsy Mathew1, Anup J Devasia, Vaggesh Ayyar

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Thyrotoxicosis, a thyroid disorder, can rarely cause acute bulbar palsy affecting swallowing and speech. Prompt treatment of hyperthyroidism led to rapid symptom recovery in a patient with Graves

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Area of Science:

  • Neurology
  • Endocrinology

Background:

  • Hyperthyroidism commonly causes myopathy, primarily affecting limb muscles.
  • Acute bulbar palsy, without skeletal muscle involvement, is an uncommon presentation of thyrotoxicosis.

Observation:

  • A 52-year-old man presented with severe dysphagia, dysphonia, and aspiration.
  • Diagnostic workup identified underlying Graves' thyrotoxicosis as the cause.

Findings:

  • The patient's bulbar symptoms resolved dramatically within six weeks of initiating hyperthyroid treatment.
  • This highlights a rare neurological manifestation of thyrotoxicosis.

Implications:

  • Thyrotoxicosis should be considered in the differential diagnosis of unexplained dysphagia.
  • Early recognition and management of hyperthyroidism can lead to significant neurological recovery.