title: Resolution of hypothyroidism after correction of somatovisceral reflex dysfunction by refusion of the cervical spine.
abstract: Psychosis is a rare initial presentation of new-onset hypothyroidism. The author describes the case of a 29-year-old woman who presented with psychosis caused by hypothyroidism, or myxedema madness. Although the patient's psychosis resolved after standard monotherapy using levothyroxine sodium, her hypothyroidism persisted. Imaging of the patient's cervical spine showed that previous C5-C6 and C6-C7 fusions had failed. The failed fusions were corrected, and the patient's hypothyroidism resolved, suggesting that the somatovisceral reflex was the cause of the patient's hypothyroidism. Although somatovisceral reflex dysfunctions are rare, physicians should consider them as potential underlying causes of their patients' presenting medical conditions.
authors.affiliation: From the Department of Osteopathic Manipulative Medicine at the Georgia Campus-Philadelphia College of Osteopathic Medicine in Suwanee murraybe@pcom.edu.
authors.forename: Murray R
authors.initials: MR
authors.lastname: Berkowitz
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000928:Antidepressive Agents / Q000008:administration & dosage; D002574:Cervical Vertebrae / Q000502:physiology / Q000503:physiopathology; D000068736:Duloxetine Hydrochloride / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000209:etiology* / Q000601:surgery*; D011618:Psychotic Disorders / Q000188:drug therapy / Q000209:etiology; D012019:Reflex Sympathetic Dystrophy / Q000150:complications* / Q000601:surgery*; D013123:Spinal Fusion; D013974:Thyroxine / Q000627:therapeutic use
chemical_list: D000701:Analgesics, Opioid; D000928:Antidepressive Agents; D000068736:Duloxetine Hydrochloride; D013974:Thyroxine