scholarly journals EXPLORING HYPERTHYROIDISM WITH A NEUROLOGICAL OUTLOOK

2020 ◽  
Vol 4 (12) ◽  
Author(s):  
Ansh Chaudhary ◽  
Amit Rastogi ◽  
Bhupendra Chaudhary
Keyword(s):  
Central Nervous System ◽  
Weight Loss ◽  
Nervous System ◽  
Thyroid Hormones ◽  
Psychiatric Disorders ◽  
Subclinical Hypothyroidism ◽  
Thyroid Diseases ◽  
Thyroid Storm ◽  
Hypermetabolic State ◽  
Life Threatening

Being one of the most common endocrinal disorders, the thyroid diseases having an extended spectrum from subclinical hypothyroidism to life threatening thyroid storm. Hyperthyroidism a hypermetabolic state with excess circulating thyroid hormones present as common systemic features like weight loss, palpitation, heat intolerance as well as peripheral and central nervous system manifestations.[1] Few of the initial neurological symptoms are often misdiagnosed as psychiatric disorders.

scholarly journals Thyroid Storm: Emergency Care for Thyrotoxicosis

2018 ◽  
Vol 2 (4) ◽  
pp. 01-02
Author(s):  
Sam Hamseley
Keyword(s):  
Central Nervous System ◽  
Heart Rate ◽  
Nervous System ◽  
Mortality Rate ◽  
Thyroid Hormones ◽  
Special Populations ◽  
Thyroid Storm ◽  
Diagnostic Strategy ◽  
Multiple Treatment ◽  
Organ Systems

Thyroid hormones affect all organ systems and, in excess, can cause increased metabolic rate, heart rate, ventricle contractility, and gastrointestinal motility as well as muscle and central nervous system excitability. Thyroid storm is the extreme manifestation of thyrotoxicosis with an estimated incidence of 0.20 per 100,000 per year among hospitalized patients in Japan. The mortality of thyroid storm without treatment ranges from 80% to 100%; but with treatment, the mortality rate is between 10% and 50%. The diagnostic strategy for thyroid storm may take into consideration Burch–Wartofsky scoring or Akamizu's diagnostic criteria. Multiple treatment aims need to be addressed in managing thyroid storm effectively. This paper puts together all aspects to be considered for the management of hyperthyroidism and thyroid storm during the acute and emergency phase as well as consideration of special populations.

scholarly journals Report of a Rare Case of Trauma-Induced Thyroid Storm

2002 ◽  
Vol 81 (8) ◽  
pp. 570-574 ◽  
Author(s):  
Neil M. Vora ◽  
Fred Fedok ◽  
Brendan C. Stack
Keyword(s):  
Nervous System ◽  
Rare Case ◽  
Hepatic Dysfunction ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Definitive Treatment ◽  
Thyroid Storm ◽  
Vehicle Accident ◽  
Hyperthyroid State ◽  
Life Threatening

Thyroid storm is a potentially life-threatening endocrinologic emergency characterized by an exacerbation of a hyperthyroid state. Several inciting factors can instigate the conversion of thyrotoxicosis to thyroid storm; trauma is one such trigger, but it is rare. Patients with thyroid storm can manifest fever, nervous system disorders, gastrointestinal or hepatic dysfunction (e.g., nausea, vomiting, diarrhea, and/or jaundice), and arrhythmia and other cardiovascular abnormalities. Treatment of thyroid storm is multimodal and is best managed by the endocrinologist and medical intensivist. Initial medical and supportive therapies are directed at stabilizing the patient, correcting the hyperthyroid state, managing the systemic decompensation, and treating the underlying cause. Once this has been achieved, definitive treatment in the form of radioactive ablation or surgery should be undertaken. We describe a case of thyroid storm in a young man that was precipitated by a motor vehicle accident.

Thyroid Disease I: Hyperthyroidism in Pregnancy

2020 ◽  
Author(s):  
Robert B. Martin ◽  
Brian Casey
Keyword(s):  
Hyperemesis Gravidarum ◽  
Beta Blockers ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Storm ◽  
Care Level ◽  
Hypermetabolic State ◽  
Life Threatening ◽  
Overt Hyperthyroidism ◽  
In Pregnancy ◽  
Stimulating Hormone

Thyroid physiologic adaptations in pregnancy may be confused with pathologic changes. Human chorionic gonadotropin rises early in pregnancy, stimulating thyrotropin secretion and suppressing thyroid stimulating hormone. These chemical changes are often seen in hyperemesis gravidarum and gestational transient thyrotoxicosis. Therefore, mild thyrotoxicosis may be difficult to differentiate from early pregnancy thyroxine stimulation.  However, overt hyperthyroidism usually includes classic symptoms seen outside of pregnancy in addition to suppressed TSH and T4 levels. Treatment includes thionamides propylthiouracil and methimazole.  Thyroid ablation is contraindicated in pregnancy. Often, in affected women, the fetus is euthyroid, but neonates can develop hyper or hypothyroidism with or without a goiter. Lastly, thyroid storm, though rare, is life threatening. Often presenting as a hypermetabolic state with cardiomyopathy and pulmonary hypertension, it generally results from decompensation from preeclampsia, anemia, sepsis, or surgery.  Treatment requires intensive care level management, with initiation of thionamides, iodine, and beta blockers.   This review contains 2 figures, 4 tables and 38 references. Keywords: Thyroid-releasing hormong, thyroid-stimulating hormone, thyromegaly, thyroid-stimulating immunoglobulins, thryotoxicosis, thionamides, thyroid storm

scholarly journals Is It Time for Systematic Voriconazole Pharmacogenomic Investigation for Central Nervous System Aspergillosis?

2018 ◽  
Vol 62 (9) ◽  
Author(s):  
François Danion ◽  
Vincent Jullien ◽  
Claire Rouzaud ◽  
Manal Abdel Fattah ◽  
Simona Lapusan ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Therapeutic Drug Monitoring ◽  
Invasive Aspergillosis ◽  
Drug Monitoring ◽  
Standard Treatment ◽  
Plasma Concentrations ◽  
Therapeutic Drug ◽  
Life Threatening ◽  
Trough Plasma

ABSTRACT Voriconazole is the standard treatment for invasive aspergillosis but requires therapeutic drug monitoring to optimize therapy. We report two cases of central nervous system aspergillosis treated with voriconazole. Because of low trough plasma concentrations, we identified gain-of-function mutations in CYP2C19 that were partially responsible for the therapeutic failure of voriconazole. We suggest that systematic voriconazole pharmacogenomic investigation of cerebral aspergillosis be performed to avoid effective therapy delay in this life-threatening disease.

Neurochemical Systems in the Central Nervous System

2013 ◽  
pp. 12-26
Author(s):  
Ariel Y. Deutch ◽  
Robert H. Roth
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Psychiatric Disorders ◽  
Neurotrophic Factors ◽  
Drugs Of Abuse ◽  
Large Majority ◽  
System P ◽  
Target Neuron ◽  
The Central Nervous System ◽  
The Brain

Chapter 2 describes the neurochemical organization of the brain. It summarizes the diverse types of molecules that neurons in the brain use as neurotransmitters and neurotrophic factors, and how these molecules are synthesized and metabolized. The chapter also presents the array of receptor proteins through which these molecules regulate target neuron functioning and the reuptake proteins that generally terminate the neurotransmitter signal. Today a large majority of all drugs used to treat psychiatric disorders, as well as most drugs of abuse, still have as their initial targets proteins involved directly in neurotransmitter function.

Serotonin Syndrome

2019 ◽  
pp. 467-471
Author(s):  
Kevin T. Gobeske ◽  
Eelco F. M. Wijdicks
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Serotonin Syndrome ◽  
Neuromuscular System ◽  
Autonomic Nervous ◽  
Life Threatening ◽  
The Central Nervous System ◽  
Serotonin Toxicity

Serotonin syndrome affects the central nervous system, the autonomic nervous system, and the neuromuscular system and can have acute and potentially life-threatening manifestations. By definition, serotonin syndrome is associated with changes in serotonin exposure and thus might be described more accurately as serotonergic excess or serotonin toxicity. The central nervous system effects of serotonin involve regulation of attention, arousal, mood, learning, appetite, and temperature.

Biological correlates of personality: considerations on the possible usefulness of central nervous system peripheral markers

1993 ◽  
Vol 8 (3) ◽  
pp. 115-124 ◽  
Author(s):  
P Castrogiovanni ◽  
F Pieraccini ◽  
I Maremmani ◽  
D Marazziti
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Psychiatric Disorders ◽  
Human Studies ◽  
Biological Research ◽  
The Central Nervous System ◽  
Methodological Problems ◽  
Biological Substrates ◽  
Peripheral Markers ◽  
Made In

SummaryAlthough a great deal of biological research has been carried out on several psychiatric disorders, it is disappointing to see how little progress has been made in the field of the biology of personality. The authors underline the methodological problems that arise in the investigation of biological substrates of human personality and review both currently available and putative peripheral markers of the central nervous system that might be used in further human studies.

Selective Unilateral Autonomic Activation: Implications for Psychiatry

CNS Spectrums ◽  
2007 ◽  
Vol 12 (8) ◽  
pp. 625-634 ◽  
Author(s):  
David S. Shannahoff-Khalsa
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Psychiatric Disorders ◽  
Autonomic Nervous ◽  
Non Invasive ◽  
Autonomic Activation ◽  
Tightly Coupled ◽  
Forced Breathing ◽  
Autonomic Reflex

ABSTRACTResearch advances have led to three methods for selectively activating one half of the autonomic nervous system in humans.The first method is an ancient yogic technique called unilateral forced nostril breathing (UFNB) that employs forced breathing through only one nostril while closing off the other. The second method works by stimulation of an autonomic reflex point on the fifth intercostal space near the axilla. The most recent method employs unilateral vagus nerve stimulation (VNS) via the mid-inferior cervical branch and requires surgical implantation of a wire and pacemaker. UFNB is non-invasive and seems to selectively activate the ipsilateral branch of the sympathetic nervous system with a possible compensation effect leading to contralateral VNS. UFNB and VNS have been employed to treat psychiatric disorders. While UFNB has been studied for its potential effects on the endogenous ultradian rhythms of the autonomic and central nervous system, and their tightly coupled correlates, VNS has yet to be studied in this regard. This article reviews these three methods and discusses their similarities, putative mechanisms, their studied effects on the endogenous autonomic nervous system and central nervous system rhythms, and their implications for the treatment of psychiatric disorders.

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