The Thyroid Gland in Relation to Neuromuscular Disease

Millikan, Clark H.

doi:10.1001/archinte.1953.00240190017002

Cited by 133 publications

(42 citation statements)

References 26 publications

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“…In the past, thyrotoxicosis with significant muscle disorders was classified as a specific disease, thyrotoxic myopathy (Zierler, 1951;Whitfield and Hudson, 1961). However, recently it has been reported that myopathy is common in thyrotoxic patients (Millikan and Haines, 1953;Hed et al, 1958;Ramsay, 1966), and Satoyoshi et al (1963) reported that the skeletal muscles are always more or less impaired in thyrotoxicosis. There have been many reports concerning the abnormal findings of the E.M.G.…”

Section: Discussionmentioning

confidence: 99%

An Evidence for the Decrease of Body Muscle Mass Due to Thyrotoxicosis and Long Term Steroid Therapy by Means of Height, Weight and Upper Arm Circumference Measurements

1972

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SynopsisA weight-corrected UAC of 109 males and 292 females with untreated thyrotoxicosis was compared with that of the same number of control subjects. Control subjects were chosen from the subjects without apparent diseases; one control for one patient with about the same age, height and weight. The mean value of the weight-corrected UAC in thyrotoxic patients was 25.4cm both in males and females. The mean value of the controls was 26.7cm in males and 26.0cm in females. These findings suggest that UAC of thyrotoxic patients is smaller than that of controls even in the same height and weight, and that there is a significant decrease of body muscle mass in thyrotoxic patients.Furthermore, it was suggested that the body muscle mass was decreased in 4 cases which had a long term steroid therapy, because the weight-corrected UAC was smaller than that of the controls.Although it is important to evaluate the degree of muscular wasting in dealing leanness, a simple method for this purpose has not been available. We have previously reported that when upper arm circumference (UAC) is corrected to the standard weight value by lineal regression equation between UAC and body weight expressed as percent deviation from the standard weight, this weight-corrected UAC is a good index of body muscle mass, and that the weight-corrected UAC declines with advancing age.There is a considerable number of studies on thyrotoxic myopathy, but little work has been done to show the change in muscle mass in thyrotoxic patients. In this paper we have attempted to calculate the weight-corrected UAC and evaluate whether body muscle mass of thyrotoxic patients is decreased or not, comparing them with control subjects. Since it is well known that patients with Cushing's syndrome have decreased UAC, an observation about patients who have received long term steroid therapy has also been made in this study. Materials and MethodsThe subjects were untreated patients with thyrotoxic diffuse goiter, 109 males and 292 females. The average age of the male patients was 38 years, including 25 cases aged 20-29, 36 aged 30-39, 33 aged 40-49, and 15 aged 50-59. The average age of the female patients was 35 years, including 105 aged 20-29, 96 aged 30-39, 63 aged 40-49 and 28 aged 50-59. Control subjects were chosen from the subjects without thyrotoxicosis and other apparent diseases; one control for one patient with about the same age, height and weight. UAC was measured at right mid-upper arm in a vertical position. As the standard weight is used the heightweight table, reported preciously (Matsuki and Yoda, 1972). The weight was expressed as percent deviation from the standard weight.

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Section: Discussionmentioning

confidence: 99%

An Evidence for the Decrease of Body Muscle Mass Due to Thyrotoxicosis and Long Term Steroid Therapy by Means of Height, Weight and Upper Arm Circumference Measurements

1972

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“…Millikan & Haines (1953) found normal electro-myograms (EMGs), though since their report Bostrom & Hed (1958), Hed, Kirstein & Lundmark (1958), Whitfield & Hudson (1961) and Havard (1962) have all reported typical myopathic patterns in their patients with clinical thyrotoxic myopathy.…”

Section: Muscle Enzymesmentioning

confidence: 99%

“…Two patients (Sanderson & Adey, 1952;Millikan & Haines, 1953) had had cramps in their legs, while Hoffenburg & Eales (1956) described a man with pain and stiffness in his muscles and contractures, and muscular aching was a feature noted by Whitfield & Hudson Ian Ramsay (1961) in one patient. In the patients with bulbar involvement difficulty in speaking was the most common symptom and consisted of dysphonia, hoarseness and weakness of speech or an alteration in the quality of the voice.…”

Section: Featuresmentioning

confidence: 99%

“…Most of the previously published papers have given quantitative estimations of the electromyographic findings in thyrotoxicosis, and so the results are subject to observer error. This may explain the normal EMGs in the patients of Millikan & Haines (1953). If, however, a quantitative method of electromyography is used (Ramsay, 1965;Yates, 1965) in which twenty to twenty-seven different areas in each muscle are sampled and the mean action-potential duration is compared to the normal for that patient's age, then a higher degree of accuracy may be achieved.…”

Section: Muscle Enzymesmentioning

confidence: 99%

“…Since then there has been argument as to whether these patients had acute thyrotoxic myopathy or encephalopathy or whether they had myasthenia gravis (Millikan & Haines, 1953). An attempt will be made in this review to show that there is probably one primary muscle disorder of hyperthyroidism, of varying severity, to which occasionally the effects of other diseases such as myasthenia gravis and periodic paralysis may be added.…”

Section: Introductionmentioning

confidence: 99%

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Thyrotoxic muscle disease

Ramsay¹

1968

Postgraduate Medical Journal

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Summary Evidence suggests that most hyperthyroid patients have a proximal myopathy. The more severe this is the more frequently are distal muscles, and ultimately, bulbar muscles involved. Probably acute thyrotoxic myopathy or encephalopathy supervenes on a previous chronic background or occurs concurrently with skeletal muscle involvement. Using careful electromyographic techniques evidence of myopathy may be found in most thyrotoxics; it disappears with adequate treatment of the primary disease. Myasthenia gravis and periodic paralysis are also associated with thyrotoxicosis and their differentiation is discussed. Infiltrative ophthalmopathy is not related to the effects of excess thyroid hormone, but is possibly due to EPS working in conjunction with LATS.

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