Kahaly G, Tettenborn B, Mihaljevic V, Beyer J, Krämer G
Abteilung für Innere Medizin und Endokrinologie, Universität Mainz.
Dtsch Med Wochenschr. 1989 Oct 20;114(42):1607-11. doi: 10.1055/s-2008-1066803.
A 68-year-old woman who, for the first time, had a generalized tonic-clonic seizure and persisting confusional state was found to have nodular enlargement of the thyroid and a tachycardic arrhythmia. Electroencephalography (EEG) demonstrated a continuous irregular polyspike wave pattern. Total T4 concentration was elevated to 23 micrograms/dl. Consecutive Administration of 250 mg phenytoin, 4 mg clonazepam and 7.5 mg midazolam changed neither the clinical nor the EEG findings. But after general intensive care measures and high-dose thyrostatic treatment (40 mg thiamazole intravenously every four hours) the clinical and neurological status became normal. Serial EEGs over the subsequent weeks and months showed gradual disappearance of the abnormal changes with increasingly prolonged periods of normal activity.
一名68岁女性首次出现全身强直阵挛性发作并伴有持续的意识模糊状态，发现甲状腺有结节性肿大及快速性心律失常。脑电图（EEG）显示为持续的不规则多棘波图形。总T4浓度升高至23微克/分升。连续给予250毫克苯妥英、4毫克氯硝西泮和7.5毫克咪达唑仑，临床及脑电图表现均未改变。但经过综合强化护理措施及高剂量抗甲状腺药物治疗（每四小时静脉注射40毫克甲巯咪唑）后，临床及神经状态恢复正常。在随后数周及数月的系列脑电图检查显示，异常改变逐渐消失，正常活动期越来越长。
