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[Deep peroneal nerve palsy associated with hypothyroidism]
T Yasuoka1, T Yokota, H Tsukagoshi
1Department of Neurology, Tokyo Medical and Dental University, Japan.
No to Shinkei = Brain and Nerve
|June 1, 1993
Summary
Hypothyroidism can cause deep peroneal nerve palsy, leading to foot drop. Prompt treatment with levothyroxine sodium can fully reverse this neuropathy.
Area of Science:
- Neurology
- Endocrinology
Background:
- Carpal tunnel syndrome is a known complication of hypothyroidism.
- Other mononeuropathies associated with hypothyroidism are rarely reported.
Observation:
- A 65-year-old male presented with fatigue and right foot drop.
- Physical examination revealed pretibial pitting edema and no muscle contraction in the right anterior tibial muscle and extensor hallucis longus.
- Electrophysiological studies showed no muscle action potentials upon stimulation of the right deep peroneal nerve.
Findings:
- The patient was diagnosed with right deep peroneal nerve palsy secondary to hypothyroidism.
- Treatment with levothyroxine sodium resulted in complete recovery of the nerve palsy and resolution of edema within two months.
- The findings suggest a conduction block in the deep peroneal nerve, possibly due to focal edema.
Implications:
- Hypothyroidism should be considered in the differential diagnosis of deep peroneal nerve mononeuropathy.
- This case highlights the potential for hypothyroidism to cause peripheral nerve dysfunction beyond carpal tunnel syndrome.
- Further research is needed to elucidate the exact mechanism (axonopathy vs. demyelination) of hypothyroidism-related neuropathies.