XXXX with generalized hyperreflexia as a presenting manifestation of thyrotoxicosis.

@entity1 @entity101 @entity5013 @entity2103 @entity591 @entity2915 @entity1282 @entity4775 @entity892 @entity121 @entity1339 @entity4653
A 22-year-old male student with no past medical illness, presented with acute onset @entity4653 , @entity892 , and @entity1282 over 10 hours. On examination, he had @entity591 , @entity101 , generalized @entity2915 , and bilateral pupil sparing oculomotor, troclear, abducens, trigeminal, facial, glossopharyngeal, and @entity4775 . Rest examination was unremarkable. @entity2103 conduction study (NCS) showed decreased amplitude bilaterally and neurogenic pattern on electromyography. Limb NCS, repetitive nerve stimulation, @entity1339 test, brain magnetic resonance imaging, cerebrospinal fluid, and biochemical tests were normal. Only positive tests were low thyroid-stimulating hormone (TSH) (<0.01), high free T3 (19.2 pmol/L), and high free T4 (39.2 pmol/L). Thyroid ultrasonography, anti-thyroid peroxidase, and anti-thyroglobulin antibody were normal. @entity1 was treated with anti-thyroid drugs, with which he completely recovered in 2 months. Though many cases with @entity121 have been reported, only few mention neuropathic cause of @entity1282 or @entity5013 cranialis. Getting done thyroid function tests may be helpful in @entity1 with @entity5013 cranialis of uncertain etiology.
