Skip to main content
SpringerLink
Log in

Schilddrüse, Nebenschilddrüse und Epilepsie

Thyroid, parathyroid glands and epilepsy

  • BEITRAG ZUM THEMENSCHWERPUNKT
  • Published:
Zeitschrift für Epileptologie Aims and scope Submit manuscript

Abstract

There is clinical evidence that endogenous (hyperthyroidism) as well as exogenous thyroxin intoxications can provoke seizures or increase seizure frequency and intensity. The latter was reported particularly for juvenile myoclonic epilepsy (JME). Hypothyroidism, on the other hand, is associated with a decreased incidence of febrile seizures. Hashimoto-encephalopathy occurs in patients with Hashimoto- thyroiditis and is a usually steroid responsive, at times spontaneously remitting, encephalopathy. Epileptic seizures occurring in 50–60%, myoclonus psychotic or confusional states and changes in the level of consciousness are frequent neuro-psychiatric symptoms. Hypoparathyroidism, usually of iatrogenic etiology, frequently presents with tetany occurring within days or weeks of the operation. However, epileptic seizures were reported in 25–30% of the cases and can emerge months to years after the operation.

Zusammenfassung

Klinische Evidenz belegt, dass endogene (Hyperthyreose) aber auch exogene Thyroxinintoxikationen anfallsauslösend oder -verstärkend wirken. Letzteres wurde vor allem bei der juvenilen myoklonischen Epilepsie berichtet. Umgekehrt gibt es Hinweise, dass die Inzidenz von Fieberkrämpfen bei Hypothyreose vermindert ist. Die Hashimoto-Enzephalopathie ist eine mit der gleichnamigen Autoimmunthyreoiditis assoziierte akute wiederkehrende steroid-responsive, z.T. spontan remittierende Enzephalopathie, bei der epileptische Anfälle (in 50–60%), Verwirrtheit, Psychose, Störungen der Vigilanz und Myoklonien beschrieben sind. Beim meist iatrogenen seltener idopathischen Hypoparathyreoidismus können neben der meist bald nach der Operation symptomatischen Tetanie in 25–30% der Fälle, oft mit deutlich längerer Latenz, auch epileptische Anfälle auftreten.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Asami T, Sasagawa F, Kyo S, Asami K, Uchiyama M (1998) Incidence of febrile convulsions in children with congenital hypothyroidism. Acta Paediatr 87(6):623–626

    Article  PubMed  CAS  Google Scholar 

  2. Aydin A, Cemeroglu AP, Baklan B (2004) Thyroxine-induced hypermotor seizure. Seizure 13(1):61–65. (Postsurgical seizure free patient develops seizures after Thyroxine substitution)

    Article  PubMed  Google Scholar 

  3. Basser LS, Neale FC, Ireland AW, Posen S (1969) Epilepsy and electroencephalographic abnormalities in chronic surgical hypoparathyroidism. Annals of Internal Medicine 71:507–515

    PubMed  CAS  Google Scholar 

  4. Boers P, Colebatch J (2001) Hashimoto’s encephalopathy responding to plasmapheresis. J Neurol Neurosurg Psychiatry 70:132

    Article  PubMed  CAS  Google Scholar 

  5. Bryce GM, Poyner F (1992) Myxoedema presenting with seizures. Postgrad Med J 68(795):35–36

    Article  PubMed  CAS  Google Scholar 

  6. Chaudhuri A, Behan PO (2003) The clinical spectrum, diagnosis, pathogenesis and treatment of Hashimoto’s encephalopathy (recurrent acute disseminated encephalomyelitis). Curr Med Chem 10(19):1945–1953

    Article  PubMed  CAS  Google Scholar 

  7. Chong JY, Rowland LP, Utiger RD (2003) Hashimoto encephalopathy: syndrome or myth? Arch Neurol 60(2):164–171

    Article  PubMed  Google Scholar 

  8. De Sanctis V, Vullo C, Bagni B, Chiccoli L (1992) Hypoparathyroidism in beta-thalassemia major. Clinical and laboratory observations in 24 patients. Acta Haematologica 88(2–3):105–108

    Article  PubMed  CAS  Google Scholar 

  9. Dimich A, Bedrossian PB, Wallach S (1967) Hypoparathyroidism – clinical observations in 34 patients. Archives of Internal Medicine 120:449–458

    Article  PubMed  CAS  Google Scholar 

  10. Fonseca OA, Calverley JR (1967) Neurological manifestations of hypoparathyroidism. Archives of Internal Medicine 120:202–206

    Article  PubMed  CAS  Google Scholar 

  11. Gayatri NA, Whitehouse WP (2005) Pilot survey of Hashimoto’s encephalopathy in children. Dev Med Child Neurol 47(8):556–558

    Article  PubMed  Google Scholar 

  12. Gazarian M, Laxer RM, Kooh SW, Silverman ED (1995) Hypoparathyroidism a ssociated with systemic lupus erythematosus. The Journal of rheumatology 22(11):2156–2158

    PubMed  CAS  Google Scholar 

  13. Halperin I, Nubiola A, Vendrell J, Vilardell E (1989) Late onset hypocalcemia appearing years after thyroid surgery. Journal of endocrinological investigation 12(6):419–420

    PubMed  CAS  Google Scholar 

  14. Hartmann M, Schaner B, Scheglmann K, Bucking A, Pfister R (2000) Hashimoto encephalo-pathy: steroid-sensitive encephalopathy in Hashimoto thyroiditis. Nervenarzt 71(6):489–494

    Article  PubMed  CAS  Google Scholar 

  15. Hussain NS, Rumbaugh J, Kerr D, Nath A, Hillis AE (2005) Effects of prednisone and plasma exchange on cognitive impairment in Hashimoto encephalopathy. Neurology 11;64(1):165–166

    Article  CAS  Google Scholar 

  16. Jabbari B, Huott AD (1980) Seizures in thyrotoxicosis. Epilepsia 21(1):91–96 (Three cases with seizures only during thyrotoxicosis)

    PubMed  CAS  Google Scholar 

  17. Kothbauer-Margreiter I, Sturzenegger M, Komor J, Baumgartner R, Hess CW (1996) Encephalopathy associated with Hashimoto thyroiditis: diagnosis and treatment. J Neurol 243(8):585–593

    Article  PubMed  CAS  Google Scholar 

  18. Lehmann JB, Leidy JW (1994) A postthyroidectomy convulsion: an unusual presentation of chronic hypoparathyroidism. The West Virginia medical journal 90(10):420–421

    PubMed  CAS  Google Scholar 

  19. Li Voon Chong JS, Lecky BR, Macfarlane IA (2000) Recurrent encephalopathy and generalised seizures associated with relapses of thyrotoxicosis. Int J Clin Pract 54(9):621–622

    PubMed  CAS  Google Scholar 

  20. Maeda K, Tanimoto K (1981) Epileptic seizures induced by thyreotropic releasing hormone. Lancet 1:1058–1059

    Article  PubMed  CAS  Google Scholar 

  21. Messing RO, Simon RP (1986) Seizures as a manifestation of systemic disease. Neurologic clinics 4:563–584

    PubMed  CAS  Google Scholar 

  22. Mrowka M, Knake S, Klinge H, Odin P, Rosenow F (2004) Hypocalcemic generalised seizures as a manifestation of iatrogenic hypoparathyroidism months to years after thyroid surgery. Epileptic Disord 6(2):85–87

    PubMed  Google Scholar 

  23. Obeid T, Awada A, al Rajeh S, Chaballout A (1996) Thyroxine exacerbates absence seizures in juvenile myoclonic epilepsy. Neurology 47(2):605–606

    PubMed  CAS  Google Scholar 

  24. Oide T, Tokuda T, Yazaki M, Watarai M, Mitsuhashi S, Kaneko K, Hashimoto T, Ohara S, Ikeda S (2004) Anti-neuronal autoantibody in Hashimoto’s encephalopathy: neuropathological, immunohistochemical, and biochemical analysis of two patients. J Neurol Sci 217(1):7–12

    Article  PubMed  CAS  Google Scholar 

  25. Parfitt AM (1972) The spectrum of hypoparathyroidism. The Journal of clinical endocrinology and metabolism 34:152–158

    Article  PubMed  CAS  Google Scholar 

  26. Primavera A, Brusa G, Novello P (1990) Thyrotoxic encephalopathy and recurrent seizures. Eur Neurol 30(4):186–188

    PubMed  CAS  Google Scholar 

  27. Reddy ST, Merrick RD (1999) Hypoparathyroidism, intracranial calcification, and seizures 61 years after thyroid surgery. Tennessee medicine 92(9):341–342

    PubMed  CAS  Google Scholar 

  28. Skanse B, Nyman GE (1956) Thyrotoxicosis as a cause of cerebral dysrhythmia and convulsive seizures. Acta Endocrinol (Copenh) 22(3):246– 263

    PubMed  CAS  Google Scholar 

  29. Steinberg H, Waldron BR (1952) Idiopathic Hypoparathyroidism. Medicine 31:133–137

    PubMed  CAS  Google Scholar 

  30. Su YH, Izumi T, Kitsu M, Fukuyama Y (1993) Seizure threshold in juvenile myoclonic epilepsy with Graves disease. Epilepsia 34(3):488–492

    Article  PubMed  CAS  Google Scholar 

  31. Taitz LS, Wales JK, Spitz L (1983) Hypocalcaemic seizures following gastrectomy. European journal of pediatrics 141(1):36–38

    Article  PubMed  CAS  Google Scholar 

  32. Takahashi S, Mitamura R, Itoh Y, Suzuki N, Okuno A (1994) Hashimoto encephalopathy: etiologic considerations. Pediatr Neurol 11(4):328–331

    Article  PubMed  CAS  Google Scholar 

  33. Tauboll E, Stokke KT, Gjerstad L, Loyning Y, Johannessen SI (1986) Association between regularly occurring complex partial seizures and thyroid function parameters. Epilepsia 27(4):419–422

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Interdisziplinäres Epilepsiezentrum am Universitätsklinikum Gießen und Marburg GmbH, Klinik für Neurologie Marburg (EZM), Rudolph-Bultmann-Straße 8, 35039, Marburg, Germany

    Felix Rosenow & Janine Reis

Authors
  1. Felix Rosenow
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Janine Reis
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rosenow, F., Reis, J. Schilddrüse, Nebenschilddrüse und Epilepsie. Z. Epileptol. 19, 183–186 (2006). https://doi.org/10.1007/s10309-006-0208-y

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10309-006-0208-y

Key words

Schlüsselwörter

Search

Navigation