Reversible Orolingual Dyskinesia: An Unknown Presentation of Hashimoto’s Toxic Encephalopathy
Reversible Orolingual Dyskinesia: An Unknown Presentation of Hashimoto’s Toxic Encephalopathy
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可逆性口语运动障碍：桥本中毒性脑病的一种未知表现
DOI：
10.17659/01.2018.0045
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
J. Anpalagan
中科院分区：
文献类型：
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作者：
A. Keshavaraj;J. Anpalagan
简介 : 本报告讲述了一位年轻女士因桥状甲状腺毒症 (HTx) 引起的口语运动障碍 (OD)，通过短期口服卡比马唑和口服类固醇后恢复正常。病例报告：一名 23 岁女性出现喉咙不适，随后情绪不稳定、说话过多，伴有舌头伸出的动作，偶尔还会出现面部鬼脸动作，提示患有 OD。此外，她患有心动过速并患有弥漫性触痛性甲状腺肿。她的 TSH 低于 0.015 mIu/mL，T4 为 4.62 nmoles/L，而抗 TPO 抗体升高至 1903 IU/mL。在没有细胞的情况下，她的脑脊液蛋白不成比例地升高（150 mg/dL）。这些特征提示桥中毒性脑病。该患者开始口服卡比马唑 15 mg，每天三次，以治疗甲状腺毒症。两周后，她开始静脉注射甲基强的松，以实现桥本脑病的完全康复。第八周时，她的临床改善达到 90%，抗 TPO 水平降至 1020 IU/mL。结论：OD 与抗 TPO 抗体升高和甲状腺毒症可能是桥本中毒性脑病的一个指标；这还没有得到很好的研究。
Introduction : This report is about a young lady displaying orolingual dyskinesia (OD) caused by Hashithyrotoxicosis (HTx) which was reversed back to normal by short course of both oral carbimazole and parental steroid. Case Report : A 23 year old female presented with throat discomfort followed by emotional lability, excessive talk, associated with protruding movements of tongue and occasionally facial grimacing like movements suggestive of OD. Further, she was tachycardic and had diffuse tender goiter. Her TSH was less than 0.015 mIu/mL and T4 was 4.62 nmoles/L while the anti-TPO antibodies were elevated to 1903 IU/mL. Her CSF protein was disproportionately elevated (150 mg/dL) with no cells. These features suggested Hashitoxic encephalopathy. This patient was started with oral carbimazole 15 mg thrice a day for the management of thyrotoxicosis. Two weeks later she was started with intravenous methyl-prednisone to achieve complete recovery of Hashimoto’s encephalopathy. At eighth week she achieved 90% clinical improvement and her anti-TPO level reduced to 1020 IU/mL. Conclusion : OD along with elevated anti-TPO antibodies and thyrotoxicosis could be an indicator of Hashimoto’s toxic encephalopathy; that is not yet well studied.