ACUTE THYROTOXIC NEUROPATHY - BASEDOWS PARAPLEGIA REVISITED

A forty seven year old woman with previously undetected goitre, develo ped thyroid storm in the immediate postoperative period. Forty eight h ours after undergoing nephrolithotomy for renal calculus, she was note d to have flaccid areflexic quadriparesis, most marked in the lower li mbs. Electrophysiologic studies revealed evidence of an asymmetric, mi xed axonal and demyelinating, motor-sensory peripheral neuropathy. Ult rastructure of the sural nerve showed predominant abnormalities in the mitochondria and cytoskeletal elements compatible with thyrotoxicosis . Treatment of thyrotoxicosis coincided with recovery of symptoms. We believe that thyrotoxicosis precipitated an acute polyneuropathy the u ltrastructure of which is being described for the first time. (C) 1998 Elsevier Science B.V.