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Cited by 447Thyroid Disorders and TreatmentsPeripheral Nerve DisordersPeripheral Neuropathies and Disorders

Neuromuscular findings in thyroid dysfunction: a prospective clinical and electrodiagnostic study

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Duyff, R. F·2000·Journal of Neurology, Neurosurgery & Psychiatry
DOI 10.1136/jnnp.68.6.750PMC PMC1736982
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Abstract

OBJECTIVES: To evaluate neuromuscular signs and symptoms in patients with newly diagnosed hypothyroidism and hyperthyroidism. METHODS: A prospective cohort study was performed in adult patients with newly diagnosed thyroid dysfunction. Patients were evaluated clinically with hand held dynamometry and with electrodiagnosis. The clinical features of weakness and sensory signs and the biochemical data were evaluated during treatment. RESULTS: In hypothyroid patients 79% had neuromuscular complaints, 38% had clinical weakness (manual muscle strength testing) in one or more muscle groups, 42% had signs of sensorimotor axonal neuropathy, and 29% had carpal tunnel syndrome. Serum creatine kinase did not correlate with weakness. After 1 year of treatment 13% of the patients still had weakness. In hyperthyroid patients 67% had neuromuscular symptoms, 62% had clinical weakness in at least one muscle group that correlated with FT4 concentrations, but not with serum CK. Nineteen per cent of the patients had sensory-motor axonal neuropathy and 0% had carpal tunnel syndrome. The neuromuscular signs developed rapidly, early in the course of the disorder and were severe, but resolved rapidly and completely during treatment (average time 3.6 months). CONCLUSIONS: Neuromuscular symptoms and signs were present in most patients. About 40% of the hypothyroid patients and 20% of the hyperthyroid patients had predominantly sensory signs of a sensorimotor axonal neuropathy early in the course of thyroid disease. Weakness in hyperthyroidism evolved rapidly at an early stage of the disorder and resolved completely during treatment, suggesting a functional muscle disorder. Hand held dynamometry is sensitive for the detection of weakness and for the clinical evaluation of treatment effects. Weakness in hypothyroidism is more difficult to treat, suggesting myopathy.

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  1. Berlit P., Mahlberg U., Usadel K. H. Zur Frage der Polyneuropathie bei Hyperthyreose--eine klinisch-neurophysiologische Studie. Schweiz Arch Neurol Psychiatr (1985) 1992;143(1):81–90. [PubMed] [Google Scholar]

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Authors
Duyff, R. F.
Affiliations
Sint Lucas Andreas Hospital (NL)
Corresponding author
Duyff, R. F
Venue
Journal of Neurology, Neurosurgery & Psychiatry
Publisher
BMJ
Published
2000-06-01
Volume
68
Issue
6
Pages
750-755
ISSN
0022-3050 (ISSN-L)
DOI
10.1136/jnnp.68.6.750
PMC
PMC1736982
OpenAlex
W2104291400
Cited by
447
References
29
Citations by year
2026: 13 · 2025: 18 · 2024: 20 · 2023: 27 · 2022: 26 · 2021: 27 · 2020: 25 · 2019: 17 · 2018: 13 · 2017: 15 · 2016: 27 · 2015: 23 · 2014: 28 · 2013: 25 · 2012: 11
FWCI
5.09
Type
journal article
Language
en
Open access
Locations
  • Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Peripheral Nerve Disorders
  • Health Sciences › Medicine › Neurology › Peripheral Neuropathies and Disorders
Keywords
hypothyroidism, hyperthyroidism, thyroid dysfunction, neuromuscular symptoms, muscle weakness, carpal tunnel syndrome, hand-held dynamometry, creatine kinase, thyroid hormone replacement, myopathy
MeSH terms
Adult, Aged, Aged, 80 and over, Carpal Tunnel Syndrome, Diagnosis, Differential, Electromyography, Female, Humans, Hyperthyroidism, Hypothyroidism, Male, Middle Aged, Neural Conduction, Neurologic Examination, Neuromuscular Diseases, Neuromuscular Junction, Prospective Studies, Thyroid Function Tests, Cohort Studies, Muscle Weakness

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