Loh Lih-Ming, Hum Allyn Y M, Teoh Hock-Luen, Lim Erle C H
Department of Endocrinology, Singapore General Hospital, Singapore, Singapore.
Parkinsonism Relat Disord. 2005 Mar;11(2):117-9. doi: 10.1016/j.parkreldis.2004.08.004. Epub 2004 Dec 8.
A 40-year-old Chinese man was admitted with 1-2 Hz spasmodic truncal flexion resembling myoclonus. He was known to be thyrotoxic, and had defaulted antithyroid therapy. Clinical examination revealed truncal flexion from contraction of the rectus abdominis, with no involvement of limbs or face and no jerking in sleep. He was biochemically thyrotoxic. Treatment with clonazepam and propylthiouracil resulted in resolution of the myoclonic jerks within the next 3 weeks. He stopped taking clonazepam within the next 3 months with no recurrence of myoclonus. He remained well until he stopped taking his antithyroid medications 9 months later, when he developed spasmodic truncal jerking again. Biochemical tests confirmed that he was hyperthyroid at this time. These movements ceased within a month of compliance with antithyroid therapy, and he has been well since. MRI of the brain and thoracic spine were unremarkable. Thyrotoxicosis is known to cause chorea and tremors, and has rarely been described in association with myoclonus.
一名40岁的中国男性因出现类似肌阵挛的1-2赫兹痉挛性躯干屈曲而入院。已知他患有甲状腺毒症，且未遵医嘱进行抗甲状腺治疗。临床检查发现，其腹直肌收缩导致躯干屈曲，四肢和面部未受累，睡眠中无抽搐。生化检查显示他处于甲状腺毒症状态。使用氯硝西泮和丙硫氧嘧啶治疗后，肌阵挛性抽搐在接下来的3周内消失。在接下来的3个月内，他停用了氯硝西泮，肌阵挛未复发。他一直状况良好，直到9个月后停止服用抗甲状腺药物，此时他再次出现痉挛性躯干抽搐。生化检查证实他此时甲状腺功能亢进。在遵医嘱进行抗甲状腺治疗1个月内，这些运动停止，此后他一直状况良好。脑部和胸椎的MRI检查无异常。已知甲状腺毒症可引起舞蹈症和震颤，与肌阵挛相关的情况很少被描述。
