Cerebellar ataxia as presenting feature of hypothyroidism

Kotwal, S. K.; Gupta, Rohan; Singh, Jang Bhadur; Mahajan, Annil

doi:10.1590/2359-3997000000121

Cited by 17 publications

(5 citation statements)

References 8 publications

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“…The search for a potentially treatable cause should include a broad spectrum of different disorders, and genetic evaluation should be considered only when other etiologies can be ruled out. Disorders commonly encountered in clinical practice such as vitamin B12 deficiency and hypothyroidism can occasionally cause ataxia and in rare cases present with it [ 2 , 3 ]. Adverse reactions to drugs (especially certain antiepileptic and chemotherapeutic agents), systemic autoimmune diseases (such as sarcoidosis, systemic lupus erythematous and Sjogren syndrome) [ 4 – 6 ], deficiencies of vitamin E and B1 (thiamine) as well as mineral deficiencies (such as copper or zinc) have all been occasionally linked with neurological symptoms, including ataxia [ 7 – 9 ].…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Cerebellar Ataxia Due to Voltage-Gated Calcium Channel and Glutamic Acid Decarboxylase Autoantibodies

2017

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Patient: Female, 55Final Diagnosis: Cerebellar ataxia due to voltage-gated calcium channel and glutamic acid decarboxylase autoantibodiesSymptoms: AtaxiaMedication: —Clinical Procedure: —Specialty: NeurologyObjective:Rare diseaseBackground:Autoimmune cerebellar ataxia can be paraneoplastic in nature or can occasionally present without evidence of an ongoing malignancy. The detection of specific autoantibodies has been statistically linked to different etiologies.Case Report:A 55-year-old African-American woman with hypertension and a past history of morbid obesity and uncontrolled diabetes status post gastric bypass four years prior to the visit (with significantly improved body mass index and hemoglobin A1c controlled at the time of the clinical encounter) presented to the office complaining of gradual onset of unsteadiness and recurrent falls for the past three years, as well as difficulties coordinating routine daily activities. The neurologic exam showed moderate dysarthria and ataxic gait with bilateral dysmetria and positive Romberg test. Routine laboratory test results were only remarkable for a mild elevation of erythrocyte sedimentation rate, and most laboratory and imaging tests for common causes of ataxia failed to demonstrate an etiology. Upon further workup, evidence of anti-voltage-gated calcium channel and anti-glutamic acid decarboxylase antibody was demonstrated. She was then treated with intravenous immunoglobulins with remarkable clinical improvement.Conclusions:We present a case of antibody-mediated ataxia not associated with malignancy. While ataxia is rarely related to autoantibodies, in such cases it is critical to understand the etiology of this disabling condition in order to treat it correctly. Clinicians should be aware of the possible association with specific autoantibodies and the necessity to rule out an occult malignancy in such cases.

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Section: Discussionmentioning

confidence: 99%

A Rare Case of Cerebellar Ataxia Due to Voltage-Gated Calcium Channel and Glutamic Acid Decarboxylase Autoantibodies

2017

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“…Carlè et al compared the efficacy of hypothyroidism-associated symptoms in predicting overt hypothyroidism in different age groups, and observed that only dyspnea, fatigue and wheezing were more prevalent in elderly patients (24). Hearing loss, ataxia, and dysgeusia are neurological symptoms frequently described in hypothyroid older patients (25). Especially among elderly, neuropsychiatric symptoms such as memory loss or depression (26), dermatologic or rheumatologic disorders (27), are commonly described and it is difficult to related them to hypothyroidism.…”

Section: Methodsmentioning

confidence: 99%

Hypothyroidism as a Predictor of Surgical Outcomes in the Elderly

et al. 2019

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There is a high prevalence of hypothyroidism in the elderly population, mainly among women. The most important cause is autoimmune thyroiditis, but also iodine deficiency, radioiodine ablation, and surgery may be responsible for hypothyroidism in elderly hospitalized patients. Thyroid-related symptoms are sometimes comparable to physiological manifestations of the aging process, and hypothyroidism may be related with many symptoms which can be present in critical patients, such as cognitive impairment, cardiovascular, gastrointestinal, and hematological alterations, and eventually myxedema coma which is a severe and life-threatening condition in older adults. Adequate thyroid hormone levels are required to achieve optimal outcomes from any kind of surgical intervention. However, only few randomized clinical trials investigated the association between non-thyroidal illness (or low-T3 syndrome), and adverse surgical outcomes, so far. The goal of this review is to discuss the role of thyroid function as a predictor of surgical outcomes in the elderly.

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“…As the disease advances, the effect of thyroxine on reversibility of ataxia gradually decreases. 6,7…”

Section: Cerebellar Degeneration and Ataxiamentioning

confidence: 99%

Adult hypothyroidism and its neurological complications

et al. 2021

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Hypothyroidism is a clinical entity very commonly encountered in clinical practices. Untreated hypothyroidism can lead to hypertension, dyslipidemia, infertility, cognitive impairment, neurological and neuromuscular involvements. Neurological complications include reversible cerebellar ataxia, dementia, peripheral neuropathy, psychosis, coma, encephalopathy (Hashimoto's encephalopathy), neuromuscular disorders. The disease identification in the initial stage remains difficult as it presents with a large number of clinical features. Neonatal screening protocols in all patients of hypothyroidism can help in the timely detection as well as treatment. Most of the neurological manifestations can be reversed on timely administration of levothyroxine which works well even in reversing of the symptoms as it reverses the metabolic abnormalities. It is important to evaluate every patient with hypothyroidism or with the suspicion of the disease for any neurological abnormalities.

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Cerebellar ataxia as presenting feature of hypothyroidism

Cited by 17 publications

References 8 publications

A Rare Case of Cerebellar Ataxia Due to Voltage-Gated Calcium Channel and Glutamic Acid Decarboxylase Autoantibodies

A Rare Case of Cerebellar Ataxia Due to Voltage-Gated Calcium Channel and Glutamic Acid Decarboxylase Autoantibodies

Hypothyroidism as a Predictor of Surgical Outcomes in the Elderly

Adult hypothyroidism and its neurological complications

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