A Rare case of Myxedema coma presenting with seizures
Author(s): Preethi CD*, Nethaji Sree Vaishnavi, Konda Sanjith, Anuradha, Viknesh Prabhu, KM Vignesh and Patel Harshvardhan Anilbhai
Abstract
An elderly woman in her 60s presented with characteristic clinical features of myxoedema coma, which is a rare medical emergency case. Myxoedema crisis is a critical form of severe hypothyroidism which has a high mortality rate. The reason behind the condition is because of low intracellular T3, the patient may present with hypothermia or coma with cardiogenic shock or respiratory depression. These types of patients may also experience organ specific symptoms. If there is involvement of nervous system, seizure is the commonest symptom but a very rare manifestation of myxoedema and also carries a very high mortality rate. To intervene the progress of the disease an immediate diagnosis is required. This can be life saving for the patient and with appropriate management; the prognosis of the patient can also improve. Seizures may develop in a hypothyroid patient as a result of hyponatremia and during this presentation, if the patient is found to have hyponatremia it indicates that the patient has moderate to severe form of myxoedema. Initial treatment goal is to correct the patient’s sodium level and followed by thyroid replacement therapy in intensive care unit along with steroids and fluid replacements.