Persistent Hemichorea Associated with Thyrotoxicosis.

Baba, Masayuki; Terada, Akinori; Hishida, R; Matsunaga, M; Kawabe, Yasunori; Takebe, Kazuo

doi:10.2169/internalmedicine.31.1144

Cited by 39 publications

(36 citation statements)

References 18 publications

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“…10,11 Our patient suffered from recurrent episodes of BCB, the appearance of which was, at least in three of four registered episodes, associated with increased levels of thyroid hormones. Between these episodes, patients showed mild, diffuse choreic movements.…”

Section: Discussionmentioning

confidence: 78%

Bilateral chorea–ballism associated with hyperthyroidism

Ristić¹,

Svetel²,

Dragašević³

et al. 2004

Movement Disorders

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We describe a 50-year-old patient with four episodes of recurrent bilateral chorea-ballism (BCB) and associated hyperthyroidism. Reappearance of BCB, associated with increased serum levels of thyroid hormones and lack of relevant changes on brain computed tomography/magnetic resonance imaging scans, suggested that the involuntary movements were likely due to thyrotoxicosis-induced biochemical changes.

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Section: Discussionmentioning

confidence: 78%

Bilateral chorea–ballism associated with hyperthyroidism

Ristić¹,

Svetel²,

Dragašević³

et al. 2004

Movement Disorders

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“…The causes of acquired chorea are infections, autoimmune diseases, genetic mutations, neurodegeneration, stroke, neoplasms, drug-exposure, vascular anomaly and metabolic diseases including thyroid disease [5][6][7]. Although about 30 cases of Hashimoto's encephalopathy associated with hypothyroidism or euthyroidism have been reported in the literature, similar signs have been reported only in the rare cases of Graves' disease [8][9][10][11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, there were reports on Graves disease related chorea combined with other disorders, such as spasmodic truncal flexion [16], severe dysphagia [11], myopathy [12,17] and ataxia [6]. However these reports showed bilateral, symmetric chorea and there were only two case reports that manifested a unilateral chorea in the left side [9,10]. Furthermore, most reported cases of Graves' disease have been in women [4] except two male cases.…”

Section: Discussionmentioning

confidence: 99%

Asymmetric chorea as presenting symptom in Graves’ disease

et al. 2011

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Chorea is an involuntary movement disorder characterized by irregular, brief movements that flow from one body part to another in a non-stereotyped fashion. In rare instances, chorea is associated with autoimmune thyroid disease. Most of them have been related with Hashimoto's encephalopathy and few cases have been related with Graves' disease. Most reported cases have been in women with Graves' disease. We describe a 16-year-old male patient with asymmetric chorea as presenting symptom in Graves' disease. He had no family history of neurological disease. Brain imaging, laboratory findings and electroencephalogram demonstrated no abnormality except for thyroid dysfunction which was proved by thyroid function test, sonography and radioiodine uptake scan. Asymmetric chorea improved over months after anti-thyroid medications. This asymmetry could be explained by difference in increased hypersensitivity or by the difference in the number of dopamine receptors, and an asymmetrical breakdown of blood-brain barrier due to their genetic differences.

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“…Our patient became free of symptoms 1 week after reduction of levothyroxine and did not need movement-suppressing drugs. Yet other patients still have involuntary movements for several weeks or longer despite normalization of thyroid function [2,11].…”

Section: Discussionmentioning

confidence: 99%

Choreathetosis due to abuse of levothyroxine

2009

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Choreathetosis due to thyrotoxicosis is a rare movement disorder of acute onset. Here we present the first report of choreathetosis secondary to abuse of levothyroxine. A 35-year-old woman with autoimmune thyroiditis tripled her daily levothyroxine intake and lost 20 kg of weight during the following 6 months. She soon developed incapacitating choreathetosis. When levothyroxine was reduced to her usual dosage, all symptoms vanished in 7 days. The prompt effect of dose correction points towards a direct influence of levothyroxine on the basal ganglia; alternatively, the effects of levothyroxine might have been indirect and, possibly, autoimmune-mediated. Abuse of levothyroxine and related thyroid-tropic substances should be included into the differential diagnosis of acute choreathetosis.

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Persistent Hemichorea Associated with Thyrotoxicosis.

Cited by 39 publications

References 18 publications

Bilateral chorea–ballism associated with hyperthyroidism

Bilateral chorea–ballism associated with hyperthyroidism

Asymmetric chorea as presenting symptom in Graves’ disease

Choreathetosis due to abuse of levothyroxine

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