Updates on Treatment in Thyroid Eye Disease for the Neurologist

Thyroid eye disease is an immune-mediated orbital disorder increasingly encountered by neurologists, presenting with optic neuropathy, diplopia, and headache. This review offers a practical, treatment-focused framework, emphasizing staging activity and severity with tools like the Clinical Activity Score and EUGOGO categories to guide management. Key steps include restoring euthyroidism, smoking cessation, and structured orbital examinations. Urgent cases with vision loss require high-dose intravenous (IV) glucocorticoids and early orbital decompression. In active disease, IV methylprednisolone combined with immunosuppressants like mycophenolate is preferred. Neurologists play a vital role in multidisciplinary care, monitoring, and patient support.