title: Status epilepticus caused by a myxoedema coma.
abstract: The case of a 63-year-old woman who presented with status epilepticus, coma and hypoventilation is reported. A primary neurological cause was considered. Hypothermia led to further investigations and a diagnosis of severe hypothyroidism. The neurological complications of hyperthyriodism include alteration in mental status with slowness, decreased concentration and lethargy, headache, cranial nerve palsies, dysarthria, hoarseness, myopathy, neuropathy, reflex changes, ataxia, and psychotic episodes. Our patient suffered from a rare consequence of severe hypothyroidism presenting with status epilepticus and she died despite treatment. To our knowledge this is the second patient to be reported with myxoedema coma with this kind of presentation. Despite therapeutic options, there is a high mortality rate.
authors.affiliation: Department of Intensive Care, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands. Henry_jansen@hotmail.com
authors.forename: H J
authors.initials: HJ
authors.lastname: Jansen
authors.forename: S R Oedit
authors.initials: SR
authors.lastname: Doebé
authors.forename: E S
authors.initials: ES
authors.lastname: Louwerse
authors.forename: J C
authors.initials: JC
authors.lastname: van der Linden
authors.forename: P M
authors.initials: PM
authors.lastname: Netten
mesh_terms: D001284:Atrophy / Q000473:pathology*; D003128:Coma / Q000150:complications*; D017809:Fatal Outcome; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007037:Hypothyroidism / Q000150:complications* / Q000188:drug therapy*; D008875:Middle Aged; D009230:Myxedema / Q000150:complications*; D012140:Respiratory Tract Diseases / Q000209:etiology; D013226:Status Epilepticus / Q000209:etiology*; D013961:Thyroid Gland / Q000473:pathology*; D013974:Thyroxine / Q000627:therapeutic use*
chemical_list: D013974:Thyroxine