Onset of reversible flaccid quadriplegia during treatment of thyrotoxic crisis
Open accessAbstract
Two unrelated women were hospitalized for thyrotoxic crisis complicated by multiple organ failure. Both patients were treated with antithyroid drugs and hydrocortisone, as well as insulin for hyperglycemia, and underwent mechanical ventilation with sedation. Flaccid quadriplegia became apparent after each patient completely recovered their level of consciousness once sedation was discontinued on days 6 and 15, respectively. Three to six months of rehabilitation was required for the muscle strength to fully improve in both cases. Thyrotoxicosis in addition to critical illness polyneuromyopathy and the administration of glucocorticoid therapy may have contributed to the onset of quadriplegia in these two cases. Flaccid quadriplegia is one of the serious neuromuscular conditions experienced during the treatment of thyrotoxic crisis.
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From the current review of the literature, there are at least 13 cases of TPP associated with glucocorticoid use.
“From the current review of the literature, there are at least 13 cases of TPP associated with glucocorticoid use [13-16].”
From Thyrotoxic Periodic Paralysis With Hypokalemia: A Case Study (2023) · cites this paper as [15]
There are few published cases of glucocorticoid administration prior to TPP.
“There are few published cases of glucocorticoid administration prior to TPP, thus the possibility that glucocorticoids may precipitate TPP requires further investigation.”
From Thyrotoxic Periodic Paralysis With Hypokalemia: A Case Study (2023) · cites this paper as [15]
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Cites
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Research works printed but not linked: 1
- Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, Eds. Saunders, Philadelphia, 2011: 362-405.
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Thyrotoxic Periodic Paralysis With Hypokalemia: A Case Study
Mebane, N. B., Khan, A., Bevinal, M., & Davis, E. (2023) · Cureus · doi:10.7759/cureus.40757 · Cited by 3 · see citing works
“From the current review of the literature, there are at least 13 cases of TPP associated with glucocorticoid use [13-16].”
Background
- Authors
- Mizokami, T., Fukui, T., Imoto, H., Fujii, H., Sato, Y., Nunoi, K., & Okamura, K.
- Affiliations
- Kyushu University (JP)
- St Mary's Hospital (JP)
- Venue
- Internal Medicine
- Published
- 2015
- Volume
- 54
- Issue
- 4
- Pages
- 421-425
- ISSN
- 0918-2918 (ISSN-L)
- 1349-7235
- OpenAlex
- W1982055659
- Cited by
- 4
- References
- 11
- Citations by year
- 2023: 1 · 2019: 1 · 2018: 1 · 2015: 1
- FWCI
- 0.58
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Keywords
- thyroid storm, critical illness polyneuromyopathy, cortisol, antithyroid drugs, multiple organ failure, neuromuscular complications, muscle strength recovery
- MeSH terms
- Female, Humans, Japan, Middle Aged, Quadriplegia, Antithyroid Agents, Thyroid Crisis, Treatment Outcome, Muscle Strength
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