Neurological Manifestations of Thyroid Disease Follow-up

Updated: Sep 18, 2017
  • Author: Gabriel Bucurescu, MD, MS; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Follow-up

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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