Onset of reversible flaccid quadriplegia during treatment of thyrotoxic crisis

Tetsuya Mizokam, Takuko Fukui, Hirofumi Imoto, Hiroki Fujii, Yuichi Sato, Kiyohide Nunoi, Ken Okamura

Research output: Contribution to journalArticle

Abstract

Two unrelated women were hospitalized for thyrotoxic crisis complicated by multiple organ failure. Both patients were treated with antithyroid drugs and hydrocortisone, as well as insulin for hyperglycemia, and underwent mechanical ventilation with sedation. Flaccid quadriplegia became apparent after each patient completely recovered their level of consciousness once sedation was discontinued on days 6 and 15, respectively. Three to six months of rehabilitation was required for the muscle strength to fully improve in both cases. Thyrotoxicosis in addition to critical illness polyneuromyopathy and the administration of glucocorticoid therapy may have contributed to the onset of quadriplegia in these two cases. Flaccid quadriplegia is one of the serious neuromuscular conditions experienced during the treatment of thyrotoxic crisis.

Original languageEnglish
Pages (from-to)421-425
Number of pages5
JournalInternal Medicine
Volume54
Issue number4
DOIs
Publication statusPublished - Jan 1 2015

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Thyroid Crisis
Quadriplegia
Antithyroid Agents
Thyrotoxicosis
Multiple Organ Failure
Muscle Strength
Consciousness
Artificial Respiration
Critical Illness
Hyperglycemia
Glucocorticoids
Hydrocortisone
Therapeutics
Rehabilitation
Insulin

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Mizokam, T., Fukui, T., Imoto, H., Fujii, H., Sato, Y., Nunoi, K., & Okamura, K. (2015). Onset of reversible flaccid quadriplegia during treatment of thyrotoxic crisis. Internal Medicine, 54(4), 421-425. https://doi.org/10.2169/internalmedicine.54.2954

Onset of reversible flaccid quadriplegia during treatment of thyrotoxic crisis. / Mizokam, Tetsuya; Fukui, Takuko; Imoto, Hirofumi; Fujii, Hiroki; Sato, Yuichi; Nunoi, Kiyohide; Okamura, Ken.

In: Internal Medicine, Vol. 54, No. 4, 01.01.2015, p. 421-425.

Research output: Contribution to journalArticle

Mizokam, T, Fukui, T, Imoto, H, Fujii, H, Sato, Y, Nunoi, K & Okamura, K 2015, 'Onset of reversible flaccid quadriplegia during treatment of thyrotoxic crisis', Internal Medicine, vol. 54, no. 4, pp. 421-425. https://doi.org/10.2169/internalmedicine.54.2954
Mizokam, Tetsuya ; Fukui, Takuko ; Imoto, Hirofumi ; Fujii, Hiroki ; Sato, Yuichi ; Nunoi, Kiyohide ; Okamura, Ken. / Onset of reversible flaccid quadriplegia during treatment of thyrotoxic crisis. In: Internal Medicine. 2015 ; Vol. 54, No. 4. pp. 421-425.
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