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Case Reports in Endocrinology
Volume 2017, Article ID 4285457, 5 pages
https://doi.org/10.1155/2017/4285457
Case Report

Myxedema Crisis Presenting with Seizures: A Rare Life-Threatening Presentation—A Case Report and Review of the Literature

Endocrinology, Colombo South Teaching Hospital, Kalubowila, Sri Lanka

Correspondence should be addressed to Sonali Sihindi Chapa Gunatilake; moc.liamg@ekalitanugilanos

Received 30 December 2016; Revised 6 April 2017; Accepted 10 April 2017; Published 2 May 2017

Academic Editor: Osamu Isozaki

Copyright © 2017 Sonali Sihindi Chapa Gunatilake and Uditha Bulugahapitiya. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Myxedema crisis is a life-threatening extreme form of hypothyroidism with a high mortality rate if left untreated. Myxedema crisis is commonly seen in older patients, especially in women, and is associated with signs of hypothyroidism, hypothermia, hyponatraemia, hypercarbia, and hypoxemia. Patients might present with different organ specific symptoms. Seizures are a recognized but rare manifestation of myxedema with a very high mortality rate. Prompt diagnosis and appropriate management may improve the prognosis. Many contributory factors may involve development of seizures in a patient with myxedema. Hyponatraemia is one such cause, which is seen in moderate-severe form in the background of myxedema. We report an elderly male who presented with generalized tonic clonic seizure preceded by memory impairment and drowsiness. He had moderate hyponatraemia and very high thyroid stimulatory hormone levels in association with low free thyroxin levels. Diagnosis of myxedema crisis was made and patient was successfully treated with sodium correction and thyroid hormone replacement.