Li Voon Chong J S, Lecky B R, Macfarlane I A
Department of Endocrinology, University Hospital Aintree.
Int J Clin Pract. 2000 Nov;54(9):621-2.
Seizures or encephalopathy associated with thyrotoxicosis are very rare. A 30-year-old man with thyrotoxicosis and strongly positive thyroid antibodies presented with generalised seizures preceded by an encephalopathic illness of a few days duration. CSF protein was raised and EEG showed bilateral slowing of activity. Antithyroid drug treatment rendered him biochemically euthyroid, his cognitive state returned to normal and his seizures stopped. Subsequently he had a recurrence of both encephalopathy and seizures on two occasions, coinciding with relapses of the thyrotoxicosis. This supports the view that the hyperthyroid state caused this serious neurological condition. Treatment with 131I caused hypothyroidism and he has remained seizure free and well for six years on thyroxine replacement. Corticosteroids may have been helpful in the management of his encephalopathy.
与甲状腺毒症相关的癫痫发作或脑病非常罕见。一名30岁患有甲状腺毒症且甲状腺抗体呈强阳性的男子，在出现持续数天的脑病后发生全身性癫痫发作。脑脊液蛋白升高，脑电图显示双侧活动减慢。抗甲状腺药物治疗使他的生化指标恢复到甲状腺功能正常状态，认知状态恢复正常，癫痫发作停止。随后，他曾两次复发脑病和癫痫发作，均与甲状腺毒症复发同时发生。这支持了甲状腺功能亢进状态导致这种严重神经系统疾病的观点。用131I治疗导致甲状腺功能减退，他在服用甲状腺素替代治疗的六年中一直未再发作癫痫且状况良好。皮质类固醇可能对他的脑病治疗有帮助。
