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Neurologic Complications of Hyperthyroidism: Title and subTitle BreakRemission of Spastic Paraplegia, Dementia, and Optic Neuropathy

Carel Bulens, MD
[+] Author Affiliations

Accepted for publication Dec 12, 1980.

Reprint requests to Department of Neurology, Academic Hospital Rotterdam-Dijkzigt, Dr Molewaterplein 40, 3015 GD Rotterdam, the Netherlands (Dr Bulens).


Arch Neurol. 1981;38(10):669-670. doi:10.1001/archneur.1981.00510100097022
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Neurologic complications of hyperthyroidism are numerous.1 The patient described here was not known to have thyroid disease and was initially observed to have a combination of spastic paraplegia, dementia, and optic neuropathy. All signs and symptoms improved dramatically within two months of the institution of carbimazole treatment. The optic neuropathy was unusual because there were no clinical or radiological signs of orbital disease.

REPORT OF A CASE  A 72-year-old man was admitted with a six-month history of a slowly progressive gait disturbance, which consisted of weakness of the legs and loss of balance. In addition, he had become confused and uninterested in his surroundings during the last two years. He could not go out alone because he easily lost his way. Both symptoms had greatly worsened during the three weeks before admission. He had become severely apathetic, could not walk, and on several occasions had been incontinent of

REFERENCES

Green R:  The thyroid gland: Its relationship to neurology , in Vinken PJ, Bruyn GW (eds): Handbook of Clinical Neurology . Amsterdam, North-Holland Publishing Co, 1976;, vol 27, pp 255-278.
Garcia CA, Flemming RH:  Reversible corticospinal tract disease due to hyperthyroidism . Arch Neurol 1977;;34:647-648.
Trobe JD, Glaser JS, Laflamme P:  Dysthyroid optic neuropathy: Clinical profile and rationale for management . Arch Ophthalmol 1978;;96:1199-1209.
Klingele TG, Hart WM, Burde RM:  Management of dysthyroid optic neuropathy . Ophthalmologica 1977;;174:327-335.
Gorman CA, DeSanto LW, MacCarty CS, et al:  Optic neuropathy of Graves's disease: Treatment by transantral or transfrontal orbital decompression . N Engl J Med 1974;;290:70-75.
Enzmann D, Marshall WH, Rosenthal AR, et al:  Computed tomography in Graves' ophthalmopathy . Radiology 1976;;118:615-620.
Jacobs L, Weiswerg LA, Kinkel WR: Computerized Tomography of the Orbit and Sella Turcica . New York, Raven Press, 1980;, pp 69-85.
Ravin JG, Sisson JC, Knapp WT:  Orbital radiation for the ocular changes of Graves' disease . Am J Ophthalmol 1975;;79:285-288.
Lahey FH:  Nonactivated (apathetic) type of hyperthyroidism . N Engl J Med 1931;;204:747-748.
Lahey FH:  Apathetic thyroidism . Ann Surg 1931;;93:1026-1030.
McGee RR:  Apathetic thyroidism: A review of the literature and report of four cases . Ann Intern Med 1959;;50:1418-1432.
Thomas FB, Mazzaferri EL, Skillmann TG:  Apathetic thyrotoxicosis: A distinctive clinical and laboratory entity . Ann Intern Med 1970;;72:679-685.

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Green R:  The thyroid gland: Its relationship to neurology , in Vinken PJ, Bruyn GW (eds): Handbook of Clinical Neurology . Amsterdam, North-Holland Publishing Co, 1976;, vol 27, pp 255-278.
Garcia CA, Flemming RH:  Reversible corticospinal tract disease due to hyperthyroidism . Arch Neurol 1977;;34:647-648.
Trobe JD, Glaser JS, Laflamme P:  Dysthyroid optic neuropathy: Clinical profile and rationale for management . Arch Ophthalmol 1978;;96:1199-1209.
Klingele TG, Hart WM, Burde RM:  Management of dysthyroid optic neuropathy . Ophthalmologica 1977;;174:327-335.
Gorman CA, DeSanto LW, MacCarty CS, et al:  Optic neuropathy of Graves's disease: Treatment by transantral or transfrontal orbital decompression . N Engl J Med 1974;;290:70-75.
Enzmann D, Marshall WH, Rosenthal AR, et al:  Computed tomography in Graves' ophthalmopathy . Radiology 1976;;118:615-620.
Jacobs L, Weiswerg LA, Kinkel WR: Computerized Tomography of the Orbit and Sella Turcica . New York, Raven Press, 1980;, pp 69-85.
Ravin JG, Sisson JC, Knapp WT:  Orbital radiation for the ocular changes of Graves' disease . Am J Ophthalmol 1975;;79:285-288.
Lahey FH:  Nonactivated (apathetic) type of hyperthyroidism . N Engl J Med 1931;;204:747-748.
Lahey FH:  Apathetic thyroidism . Ann Surg 1931;;93:1026-1030.
McGee RR:  Apathetic thyroidism: A review of the literature and report of four cases . Ann Intern Med 1959;;50:1418-1432.
Thomas FB, Mazzaferri EL, Skillmann TG:  Apathetic thyrotoxicosis: A distinctive clinical and laboratory entity . Ann Intern Med 1970;;72:679-685.

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