Thyrotoxicosis as a Cause of Epilepsy Exacerbation
Abstract number :
3.32
Submission category :
4. Clinical Epilepsy / 4B. Clinical Diagnosis
Year :
2024
Submission ID :
423
Source :
www.aesnet.org
Presentation date :
12/9/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Moza Alzaabi, MD – Cleveland Clinic Abu Dhabi
Himanshu Soni, MD – Cleveland Clinic Abu Dhabi
Maria Rabbani, MD – Cleveland Clinic Abu Dhabi
Ayman Haykal, MD – Cleveland Clinic Abu Dhabi
Rationale: Thyrotoxicosis has been reported to be rarely associated with seizures. We report 2 cases of genetic generalized epilepsy where hyperthyroidism was associated with exacerbation of epilepsy and significant increase in absence or eyelid myoclonic as well as generalized tonic-clonic seizures.
Methods: Thyrotoxicosis has been reported to be rarely associated with seizures. We report 2 cases of genetic generalized epilepsy where hyperthyroidism was associated with exacerbation of epilepsy and a significant increase in absence and generalized tonic-clonic seizures.
Results: Both patients experienced a significant and initially unexplained increase in absence seizures (patient 1), eyelid myoclonia (patient 2) and previously controlled tonic-clonic seizures (both patients). Electroencephalography (EEG) recorded frequent generalized epileptiform discharges. In both patients, the reported increase in seizures coincided with complaints palpitations and weight loss. Laboratory workup revealed TSH levels of < 0.01 mIU/L (both), free T4 levels of 100 (patient 1) and 85.6 pmol/L (patient 2) as well as elevated thyroglobulin antibodies. A diagnosis of Graves’ disease was made in both patients and they were started on carbimazole with subsequent normalization of TSH and T4 levels and reattainment of seizure control. During the follow-up period, breakthrough seizures correlated with recurrent hyperthyroidism after reducing carbimazole doses.
Clinical Epilepsy