Acute Psychotic State due to Hyperthyroidism Following Excision of a Mandible Bone Tumor: A Case Report

下顎腫瘤切除術後出現甲狀腺機能亢進之急性精神病狀態 ─ 病例報告

楊尚儒(Shang-Ju Yang) ； 王興耀(Shin-Yaw Wang) ； 陳正宗(Cheng-Chung Chen)

《The Kaohsiung Journal of Medical Sciences》 19卷1期 (2003/01) Pp. 29-32

https://doi.org/10.6452/KJMS.200301.0029

摘要

針對手術後急性精神病狀態之鑑別診斷，應需考慮甲狀腺機能亢進之可能性。本文報告一個案於下顎腫瘤切除術後，出現甲狀腺機能亢進之症狀表現、鑑別診斷與處置。個案為48歲已婚女性，接受下顎腫瘤手術後出現焦慮、心情起伏大、失眠、及聽幻覺。先以haloperidol及lithium治療約一週後，再加上methimazole治療，全部精神症狀在兩週後完全消失。三個月後停止服藥，經一年追蹤顯示病情並未再復發。

關鍵字

下顎腫瘤切除術 ； 甲狀腺機能亢進 ； 急性精神病

並列摘要

The etiology of psychotic symptoms that emerge following surgery needs to be sought to allow physicians to provide effective treatment. We present the case of a patient who developed hyperthyroidism shortly after excision of a mandible bone tumor and discuss its clinical features, course, and management. A 48-year-old female without previous thyroid disease accidentally found a tumor over her left mandible bone and underwent excision of the tumor. Soon after surgery, she suffered from anxiety, mood swings, insomnia, and even auditory hallucinations. Through careful differential diagnosis and a series of examinations, she was shown to be in a hyperthyroid state. Her condition improved after short-term use of haloperidol, lithium, and methimazole. Her thyroid function recovered and she was free from any psychiatric symptoms during the I-year follow-up. Hyperthyroidism following surgery is not uncommon and its possibility should be considered when making differential diagnoses.

並列關鍵字

mania ； psychosis ； hyperthyroidism ； surgery