title: [Bulbar paralysis and flaccid tetraparesis in thyrotoxicosis].
abstract: We describe the case of an aged patient, presenting an acute onset of flaccid paralysis of the limbs and bulbar weakness, complicated by ab ingestis pneumonia. These neurological findings were the first signs of a thyrotoxic crisis and showed a progressive regression together with the healing of the hyperthyroidism obtained, within two months, utilizing thyroid inhibitors. At the onset, a marked hypokalaemia was present, making possible the hypothesis of a thyrotoxic periodic paralysis. The hypokalaemia was corrected after many infusions of KCl i.v., without obtaining significant modifications of the neurological picture. Taking into consideration the evolution and the results of the instrumental procedures (EMG, MRI) we believe this a rare case of thyrotoxic acute myopathy, with bulbar involvement, casually associated to hypokalaemia.
authors.affiliation: Divisione di Medicina II, Ospedale G. Salvini, Garbagnate Milanese.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bertola
authors.forename: Carlo
authors.initials: C
authors.lastname: Ausenda
authors.forename: Mario
authors.initials: M
authors.lastname: Bocchia
authors.forename: Franco
authors.initials: F
authors.lastname: Grassi
authors.forename: Marco
authors.initials: M
authors.lastname: Ciani
authors.forename: Luigi
authors.initials: L
authors.lastname: Sassi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D013956:Antithyroid Agents / Q000627:therapeutic use; D010244:Bulbar Palsy, Progressive / Q000175:diagnosis / Q000209:etiology*; D004576:Electromyography; D005260:Female; D006801:Humans; D007008:Hypokalemia / Q000150:complications; D008279:Magnetic Resonance Imaging; D011782:Quadriplegia / Q000175:diagnosis / Q000209:etiology*; D013958:Thyroid Crisis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D013971:Thyrotoxicosis / Q000150:complications* / Q000188:drug therapy
chemical_list: D013956:Antithyroid Agents
vernacular_title: Paralisi della muscolatura bulbare associata a tetraparesi flaccida in corso di tireotossicosi.