Sidibe E H, Diagne P M, Ly A B, Ndiaye I P, Sow A M
Service de Médecine Interne, Centre Marc Sankale, Hôpital Abass Ndao, Sénégal.
Rev Neurol (Paris). 1998 May;154(4):330-3.
Chronic thyreotoxic neuromyopathy was observed in four patients. The first two cases were observed in a 43-year-old woman and a 60-year-old man. In the man, muscle disorders were the first manifestation and in the woman they were preceded by Graves' hyperthyroidism. Muscle signs were seen as functional impotency with amyotrophy of the girdle which was major in the man and minor in the woman. In a third case, a pyramidal syndrome was associated with polyneuropathy in a 28-year old man. Laboratory tests showed hyperthyroidism, neurological signs regressed with antithyroid drug therapy. A fourth case presented as thyrotoxic hypokaliemic periodic palsy in a 37-year-old man who had loss 12 kg over a two month period after a psychological stress. This man then experienced two acute episodes of hypokaliemia and hypotonic tetraplegia. These signs were linked to Graves' hyperthyroidism. Clinical course was good under carbimazole and then radioactive iodine. These four cases illustrate the reality of thyrotoxic neuromyopathies in black Africans.
在4例患者中观察到慢性甲状腺毒症性神经病变。前两例分别见于一名43岁女性和一名60岁男性。在该男性中,肌肉疾病是首发表现,而在该女性中,肌肉疾病之前有格雷夫斯甲状腺功能亢进症。肌肉体征表现为功能性肌无力伴肩胛带肌萎缩,男性较为严重,女性较轻。在第三例中,一名28岁男性出现锥体束综合征并伴有多发性神经病。实验室检查显示甲状腺功能亢进,抗甲状腺药物治疗后神经体征消退。第四例是一名37岁男性,表现为甲状腺毒症性低钾性周期性麻痹,在心理压力后两个月内体重减轻了12公斤。该男性随后经历了两次低钾血症和低张性四肢瘫的急性发作。这些体征与格雷夫斯甲状腺功能亢进症有关。在服用卡比马唑然后接受放射性碘治疗后,临床病程良好。这4例病例说明了非洲黑人中甲状腺毒症性神经病变的实际情况。