Thyrotoxic muscle disease

Abstract

Summary Evidence suggests that most hyperthyroid patients have a proximal myopathy. The more severe this is the more frequently are distal muscles, and ultimately, bulbar muscles involved. Probably acute thyrotoxic myopathy or encephalopathy supervenes on a previous chronic background or occurs concurrently with skeletal muscle involvement. Using careful electromyographic techniques evidence of myopathy may be found in most thyrotoxics; it disappears with adequate treatment of the primary disease. Myasthenia gravis and periodic paralysis are also associated with thyrotoxicosis and their differentiation is discussed. Infiltrative ophthalmopathy is not related to the effects of excess thyroid hormone, but is possibly due to EPS working in conjunction with LATS.

Dysphagia as a Manifestation of Thyrotoxicosis: Report of ThreeCases and Literature Review

“…The swallowing disorder could be resolved completely within 3 weeks after treatment for thyrotoxicosis. In light of these clinical experiences, early intensive treatment that includes antithyroid agent, beta-blocker, and Lugol solution may be necessary.Dysphagia is considered an extremely rare manifestation of neuromuscular disorders in thyrotoxicosis [1][2][3]. Ramsay [2] found that bulbar palsy associated with thyrotoxicosis did not occur without chronic thyrotoxic myopathy.…”

Thyrotoxicosis Complicated with Dysphagia

“…Dysphagia is considered an uncommon symptom of thyrotoxic myopathy (1)(2)(3), although skeletal muscle weakness and atrophy are frequently associated with thyrotoxicosis (4,5). There is only one Japanese case report, which has shown dysphagia complicated with hyperthyroidsim (6).…”

“…Here, we report a case of thyroid storm with dysphagia, which improved after treatment of thyrotoxicosis. (2). Moreover, muscle weakness is not in proportion to degree of its atrophy.…”

“…Most of the patients with dysphagia in thyrotoxicosis complain of preceding muscle weakness. However, it has been reported that thyrotoxic patients rarely experience a sudden bulbar muscle weakness without the presence of muscle wasting (1)(2)(3)12 (8) and myasthenia gravis (2,5,9). Most importantly, myasthenia gravis must be ruled out because it develops less than 3-10 % of hyperthyroid patients, while hyperthyroidism develops in approximately 25-30 % of myasthenic patients during the disease course (7).…”

“…The possible causes of dysphagia in thyrotoxicosis include neuromuscular dysfunction (7), i.e. bulbar or esophageal myopathy, thyrotoxic periodic hypokalemic paralysis (8) and myasthenia gravis (2,5,9) as well as mechanical compression of enlarged goiter. Here, we report a case of thyroid storm with dysphagia, which improved after treatment of thyrotoxicosis.…”