Clinical endocrinological diagnosis was established based on the thyromegaly and euthyroid status.
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Neuropsychiatric manifestations seen in patients with goiter from the study group included: 1. Psychiatric accuses: 63 cases — Psychiatric disorders encountered in the study group included somatization disorders with dissociative symptoms, somatoform disorders, conversive disorders, anxiety and depression syndromes, relatively common in patients with euthyroid goiter.
Left transient paresthesia syndromes were common and of functional nature: — Conversive disorders — 4 cases — 2. Headaches: 52 cases — Vertigo — 38 cases — Fainting — 6 cases — 3.
NEUROLOGICAL MANIFESTATIONS IN SPORADIC EUTHYROID GOITER
Tremor — 6 cases — 3. Muscular cramps — 2 cases — 1. Osteotendinous hyperrelfexia — 2 cases — 1.
Essential trigeminal neuralgia — 1 case — 0. Clinically confirmed sensory neuropathy with disorders of superficial and profound sensory disorders in the lower limbs — 2 cases — 1. Stroke — 9 cases The prevalence of stroke in patients with euthyroid goiter from the study intraductal papilloma lactation. Neurofibromatosis — 1 case — 0. Ocular myasthenia gravis — 2 cases — 1.
Euthryoid goiter associated with multiple sclerosis, remitting — recurrent form — 1 case — 0. Associations between euthyroid goiter, myasthenia gravis, rheumatoid arthritis, systemic vasculitis with secondary neuropathy — 1 case — 0.
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The diagnosis was clinically and paraclinically confirmed through mediastinum radiography, mediastinum CT, thyroid scintigram. From the patients, 4 have undergone surgery followed by substitution with thyroid hormone treatment in the recurrent case the patient refused another intervention. On the subsequent официальный заработок intraductal papilloma lactation that occurred every 3 months the evolution was favorable in all 4 cases, the initial signs and symptoms disappearing completely.
Patient S. Personal history: unimportant. Clinical exam: lowering of the soft palate on the right side; thyromegaly grade II. Laboratory exam: T3 — Thyroid ultrasound: both thyroid lobes were increased in size, homogeneous structure.
Thyroid scintigraphy fig 6 : Fig 6. Thyroid scinitgraphy — patient Intraductal papilloma lactation. Thoracic mediastinum CT fig.
There are no encountered mediastinum adenopathies nor in the pulmonary hilum. E, fig. Anizofollicular aspect, epithelial hyperactivity is intraductal papilloma lactation, with maximum use of the colloid; The follicles have different sizes, some of them being cystic dilated; thyroid vesicles are much wider and thyroid cells are flattened, the colloid is homogeneous, intensely colored.
Paraclinically the endocrinological diagnosis of sporadic euthyroid goiter was established by: — Hormonal dosages; — Thyroid ultrasound fig. Isthmus has a size of 7mm. The right thyroid lobe intraductal papilloma lactation occupied by nodular structures, the biggest one being located median, with a diameter of 14 mm. Inhomogeneous capture on the intraductal papilloma lactation area of theright thyroid lobe. Inhomogeneous capture in both lobes, sketching a hypocaptation area in the left lobe, in the inferior — exterior side, intraductal papilloma lactation the small area of hypocaptation in the lower pole of the right lobe.
These investigations have been exemplified above. The paraclinical neurological diagnosis included: — FO exam; — Electromyographic examination; — Neuroimaging CT examination; In the study group we encountered associations of signs of hyperprolactinemia galactorrheawith elevated values of PRL prolactin — Brain CT disconfirmed the diagnosis.
In 6 of the cases intraductal papilloma lactation persisting vertigo and balance disorders without response to treatment, a brain CT was carried out which detected a diffuse cerebral and cerebellar atrophy. Cases of training headache associated with vertigo and thyromegaly have been evaluated through brain CT without detecting any changes in the brain.
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Also, brain CT was performed for sensory syndromes in a hemicord with prolonged evolution, detecting only cortical atrophy. Neuroimaging evaluation was imposed for the oxiuros sintomas y causas of thyro-ovarian failure with training headache, galactorrhea and fainting, with a suspicion of pituitary adenoma, but it had not been confirmed by the brain CT.
In one case with normal prolactin levels, headache, goiter and galactorrhea the diagnosis in the end was of intraductal breast papilloma. For cases with myasthenia gravis and plunging intrathoracic goiter, we performed mediastinum CT.
Also, CT examination was performed in cases intraductal papilloma lactation stroke and in cases which required the study of the orbit and exophthalmometry.
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Euthyroid goiter was not associated with any specific neurological symptoms, the changes being predominantly subjective, the psychiatric accuses being more predominant.
The persistence of some subjective accuses such intraductal papilloma lactation vertigo and headache have required neuroimaging investigations. In cases with bulky intraductal papilloma lactation or endothoracic goiter we encountered compression phenomena of the mediasinum structures or of the cervical neurovascular package.
In some situations we have registered cases of diplopia with unclear etiology, without it belonging to a neurological cause or an endocrinological one because we could not establish it with certainty. We call that diplopia may precede with a few years the installation of thyroid disorders.
We were not able to establish a direct cause or link between the two conditions, we have encountered associations between euthyroid goiter and myasthenia gravis, multiple sclerosis, neurofibromatosis and stroke. intraductal papilloma lactation