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Neurological Manifestations of Thyroid Disease Follow-up

  • Author: Gabriel Bucurescu, MD, MS; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
 
Updated: Dec 17, 2015
 

Further Outpatient Care

Pregnant patients require follow-up at least monthly. Closely observe these newborns for thyroid disease.

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Further Inpatient Care

Neurologic manifestations in thyroid diseases are manageable on an outpatient basis. Therapy is maintained for months (if not years). In most cases, neurologic abnormalities slowly resolve.

Thyroid storm and myxedema coma are exceptions. Both are emergencies that require aggressive treatment in the ICU. The mortality rate of thyroid storm can be as high as 20-40%. The symptoms usually are exaggerated manifestations of the symptoms seen in hyperthyroidism; a superimposed infection and the stress associated with it would exacerbate the symptoms. Fever, abdominal pain, delirium, and psychosis can occur. The patient may become obtunded. Thyroid storm should be suspected in any patient with severe hyperpyrexia, tachycardia, and a goiter.

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Prognosis

Prognosis is generally good, since most symptoms are reversible with correction of the underlying problem. Neurologic complications are seldom fatal.

Congenital complications of iodine deficiency lead to cretinism and neonatal myxedema.

Untreated myxedema may lead to myxedema coma and eventually to death in children and adults.

Severity of symptoms of thyroid disease varies with the degree and duration of the deficiency.

Some degree of myopathy is found in about 50% of thyrotoxic patients.

Thyroid storm is an emergency requiring rapid therapy to prevent death.

Although now uncommon, postoperative thyroid disease can be seen.

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Patient Education

For patient education resources, see the Endocrine System Center, as well as Thyroid Problems.

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Contributor Information and Disclosures
Author

Gabriel Bucurescu, MD, MS Staff Neurologist, Neurology Service, Philadelphia Veterans Affairs Medical Center

Gabriel Bucurescu, MD, MS is a member of the following medical societies: American Academy of Neurology, American Clinical Neurophysiology Society, American Epilepsy Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Nicholas Lorenzo, MD, MHA, CPE Founding Editor-in-Chief, eMedicine Neurology; Founder and CEO/CMO, PHLT Consultants; Chief Medical Officer, MeMD Inc

Nicholas Lorenzo, MD, MHA, CPE is a member of the following medical societies: Alpha Omega Alpha, American Association for Physician Leadership, American Academy of Neurology

Disclosure: Nothing to disclose.

Additional Contributors

Thomas A Kent, MD Professor and Director of Stroke Research and Education, Department of Neurology, Baylor College of Medicine; Chief of Neurology, Michael E DeBakey Veterans Affairs Medical Center

Thomas A Kent, MD is a member of the following medical societies: American Academy of Neurology, Royal Society of Medicine, Stroke Council of the American Heart Association, American Neurological Association, New York Academy of Sciences, Sigma Xi

Disclosure: Nothing to disclose.

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