Thyrotoxicosis Presenting as a Movement Disorder

以不自主運動症表現的甲狀腺毒症

張良慧(Liang-Huey Chang)

《台灣精神醫學》 21卷3期 (2007/09) Pp. 225-229

https://doi.org/10.29478/TJP.200709.0009

摘要

目的：甲狀腺毒症之神經及情感症狀經常被誤診為是精神疾病而非生理。舞蹈手足徐動症曾經被報導為甲狀腺毒症的症狀之一。如遇到有不自主運動之個案，我們須要考慮甲狀腺亢進的可能性。病例報告：一位12歲女生，因有不自主抖動讓家人以為是學校壓力所導致而求助於精神科門診。病患前頸腫大故懷疑有內分泌問題，所以在予驗甲狀腺功能後發現有甲狀腺毒症。個案接受抗甲狀腺藥物propylthiouracil(PTU)等治療後，不自主動作逐漸消失。結論：甲狀腺毒症常見的症狀和許多精神疾病的症狀很像。對於有不自主運動症病患，我們需要提高警覺才能準確的診斷出這類合併有生理和心理症狀之甲狀腺毒症。

關鍵字

舞蹈手足徐動症 ； 甲狀腺亢進 ； 甲狀腺荷爾蒙 ； 甲狀腺毒症

並列摘要

Objective: The clinical manifestations of hyperthyroidism often overlap with those seen in psychiatric illnesses. We present a case of thyrotoxicosis-related movement disorder that was initially thought of as being a stress-related manifestation. Increasing awareness of the possible nature of choreoathetosis enhances the correct diagnosis of thyrotoxicosis. Case Report: A 12-year-old girl with generalized involuntary movement presented at our psychiatry outpatient clinic because her family thought that this was due to school-related stress. The presence of an anterior neck mass leads us to suspect that an endocrine abnormality was responsible for the choreoathetosis. Patient was subsequently found to be suffering from thyrotoxicosis. The involuntary movements disappeared following treatment with an antithyroid drug (propylthiouracil). Conclusion: The signs and symptoms of thyrotoxicosis, such as anxiety and choreoathetosis, have often misled lay persons to presume a psychological/psychiatric problem. This case demonstrates the importance for psychiatrists to consider hyperthyroidism in the differential diagnosis for patients presenting with choreiform movements.

並列關鍵字

Choreoathetosis ； hyperthyroidism ； thyrotoxicosis ； involuntary movement

參考文獻

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