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Acute thyrotoxic neuropathy--Basedow's paraplegia revisited
L Pandit1, S K Shankar, N Gayathri
1Department of Neurology, Kasturba Medical College, Manipal, Karnataka, India.
Journal of the Neurological Sciences
|April 30, 1998
Summary
Thyroid storm can cause acute polyneuropathy, affecting motor and sensory nerves. This case highlights mitochondrial and cytoskeletal abnormalities in thyrotoxicosis-induced neuropathy.
Area of Science:
- Neurology
- Endocrinology
Background:
- Thyroid storm, a severe form of thyrotoxicosis, can present with diverse systemic manifestations.
- Peripheral neuropathy is an uncommon but recognized complication of hyperthyroidism.
Observation:
- A 47-year-old woman developed flaccid areflexic quadriparesis post-nephrolithotomy, coinciding with undiagnosed goiter and subsequent thyroid storm.
- Neurological examination revealed significant weakness, predominantly in the lower limbs, with loss of reflexes.
Findings:
- Electrophysiologic studies indicated an asymmetric, mixed axonal and demyelinating, motor-sensory peripheral neuropathy.
- Sural nerve ultrastructure revealed abnormalities in mitochondria and cytoskeletal elements, consistent with thyrotoxicosis.
Implications:
- This case provides novel ultrastructural evidence of thyrotoxicosis-induced acute polyneuropathy.
- Early recognition and treatment of thyrotoxicosis are crucial for neurological recovery in affected patients.