Basedow paraplegia : a possible misnomer

Thyrotoxic myopathy frequently occurs in clinical practice; however, the association of hyperthyroidism with a flaccid, areflexic paraplegia, so-called Basedow paraplegia, appears to represent a controversial and doubtful entity. An 18-year-old female with undiagnosed and untreated Graves' dise...

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Bibliographic Details
Published in:South African medical journal 2015-10, Vol.105 (10), p.875-875
Main Authors: Smith, L., Kemp, T., Schutte, C.M.
Format: Article
Language:English
Subjects:
Case studies
Diagnosis
Graves' disease
Guillain-Barre syndrome
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Summary:Thyrotoxic myopathy frequently occurs in clinical practice; however, the association of hyperthyroidism with a flaccid, areflexic paraplegia, so-called Basedow paraplegia, appears to represent a controversial and doubtful entity. An 18-year-old female with undiagnosed and untreated Graves' disease presented with acute onset of global weakness predominantly in the lower limbs, but also affecting the upper limbs. The weakness was accompanied by hypotonia and areflexia. Clinically, the patient had a goitre and signs of thyroid ocular disease. Laboratory testing confirmed the presence of hyperthyroidism, and thyroid-stimulating hormone receptor antibodies were positive. The cerebrospinal fluid protein level was raised. The electroneuronographic and needle examinations were compatible with a clear denervation process, such as acute motor axonal neuropathy, a variant of Guillain-Barrésyndrome. Intravenous immunoglobulin therapy, carbimazole and propranolol were administered.The occurrence of hyperthyroidism with a flaccid, areflexic paraplegia appears to represent more of a fortuitous than a causative association. It is important to consider and treat other causes, such as acute idiopathic polyneuritis.
ISSN:0256-9574
2078-5135
DOI:10.7196/SAMJnew.8768