A Study on Neurological Manifestations in Thyroid Disorders.

Introduction : Thyroid disorders both hypothyroidism and hyperthyroidism can affect the entire neuro axis resulting in various neurological manifestations. Aim of the study ; To identify the neurological manifestations of patients with thyroid disorders and to emphasize the need for thyroid screening in patients with neurological symptoms Materials and methods ; 100 patients with thyroid disorders who attended Endocrinology and Neurological services at Rajiv Gandhi Govt. General hospital, Chennai, between December 2012 and February 2014 were included for the study. Patients with diabetes, renal failure, liver disorders and other chronic illness were excluded from the study. All patients underwent neurological examination and thyroid function tests. Selective investigations like neuro imaging, electroencephalogram, nerve conduction studies and electromyography were done according to the patient symptoms. Results and Discussion : Total number of patients were 100 of which 50 patients were Hypothyroid and 50 patients were Hyperthyroid. The neurological manifestations observed in hypothyroidism were headache 12%, Sleep disorders 8%, cognitive decline 4%, Hashimoto’s encephalopathy 4%, cerebellar involvement 2%, myeloneuropathy 2%, carpal tunnel syndrome 10%, peripheral neuropathy 10% and myopathy 2%. The neurological manifestations observed in hyperthyroidism were tremor 74%, headache 16%, Sleep disorders 8%, peripheral neuropathy 4%, myopathy 4% and thyrotoxic periodic paralysis 2%. Since it is observed from the study that thyroid disease can affect the entire neuro axis emphasizing the need for thyroid function testing. It important also important to screen for immunology testing like thyroid peroxidase antibody in selective cases and if found may need to treat with immunosuppression. On comparing neurological features associated with hypo and hyperthyroidism, the association is significantly high in hypothyroidism. Conclusion : Thyroid disorders can affect the entire neuro axis and may present with neurological manifestations without specific symptoms and signs of thyroid dysfunction. This emphasis the need for thyroid function testing in patients presenting with neurological symptoms even without classical thyroid symptoms