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[Pseudomyasthenic pre-Basedow ophthalmoplegia].

C Rousselle1, C Confavreux, T Moreau

  • 1Clinique Neurologique, Hôpital Neurologique, Lyon.

Revue Neurologique
|January 1, 1990
PubMed
Summary
This summary is machine-generated.

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Dysthyroid orbitopathy can manifest solely as external ophthalmoplegia, mimicking myasthenia gravis. This case highlights a rare presentation and a fatal complication of carbimazole treatment.

Area of Science:

  • Endocrinology
  • Ophthalmology
  • Neurology

Background:

  • Thyroid eye disease, or dysthyroid orbitopathy, typically presents with inflammation and proptosis.
  • Isolated external ophthalmoplegia is an uncommon initial manifestation.

Observation:

  • A 67-year-old woman developed subacute, bilateral external ophthalmoplegia resembling myasthenia gravis.
  • The condition was refractory to anticholinergic and corticosteroid therapies.
  • Subsequent diagnosis revealed biological hyperthyroidism with positive immunological markers.

Findings:

  • Intensive corticosteroid treatment yielded partial improvement.
  • The patient developed fatal bone marrow aplasia, attributed to carbimazole therapy.
  • This case suggests pure ophthalmoplegia can be the exclusive sign of dysthyroid orbitopathy.

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Implications:

  • Clinicians should consider dysthyroid orbitopathy in patients with isolated ophthalmoplegia, even without overt thyroid eye disease signs.
  • Awareness of potential drug toxicity, such as carbimazole-induced aplasia, is crucial in managing hyperthyroidism.
  • This presentation underscores the diverse clinical spectrum of thyroid-related orbitopathies.