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Thyrotoxic Periodic Paralysis With Upper Motor Neuron Findings
Gary Platt, MD;
Ronald E. Cranford, MD;
David C. Anderson, MD;
Jack E. Hubbard, MD, PhD
JAMA. 1978;240(22):2465-2466.
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RECOGNIZED neuromuscular associations of hyperthyroidism include periodic paralysis, thyrotoxic myopathy, myasthenia gravis, and exophthalmic ophthalmoplegia. Periodic paralysis, a common neuromuscular complication of thyrotoxicosis in the Orient, is rare in western countries. The syndrome is characterized by recurring episodes of flaccid weakness of the limbs with depressed or absent deep tendon reflexes. We recently cared for a young white man who had episodic quadriparesis accompanied by definite upper motor neuron findings suggesting a possible spinal cord lesion. Evaluation demonstrated severe hypokalemia as well as hyperthyroidism. Correction of the former resulted in prompt resolution of weakness; upper motor neuron findings persisted until the thyrotoxicosis was controlled.
The association of confusional syndromes, coma, seizures, and movement disorders with thyroid hyperactivity implies that the condition affects the CNS. Abnormal upper motor neuron findings also have been described in thyrotoxicosis but are thought to be rare.1 The simultaneous occurrence of a lower motor neuron complication
. . . [Full Text PDF of this Article]
Author Affiliations
From the Department of Neurology, Hennepin County (Minn) Medical Center, and the Department of Neurology, University of Minnesota Medical School, Minneapolis.
Footnotes
Reprint requests to Neurology Department, Hennepin County Medical Center, 701 Park Ave S, Minneapolis, MN 55415 (Dr Anderson).
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