Myxedema psychosis is a relatively uncommon consequence of

hypothyroidism Hypothyroidism (also called ''underactive thyroid'', ''low thyroid'' or ''hypothyreosis'') is a disorder of the endocrine system in which the thyroid gland does not produce enough thyroid hormone. It can cause a number of symptoms, such as po ...

, such as in Hashimoto's thyroiditis or in patients who have had the thyroid surgically removed and are not taking thyroxine. A chronically under-active

thyroid The thyroid, or thyroid gland, is an endocrine gland in vertebrates. In humans it is in the neck and consists of two connected lobes. The lower two thirds of the lobes are connected by a thin band of tissue called the thyroid isthmus. The thy ...

can lead to slowly progressive

dementia Dementia is a disorder which manifests as a set of related symptoms, which usually surfaces when the brain is damaged by injury or disease. The symptoms involve progressive impairments in memory, thinking, and behavior, which negatively affe ...

delirium Delirium (also known as acute confusional state) is an organically caused decline from a previous baseline of mental function that develops over a short period of time, typically hours to days. Delirium is a syndrome encompassing disturbances in ...

, and in extreme cases to hallucinations,

coma A coma is a deep state of prolonged unconsciousness in which a person cannot be awakened, fails to respond normally to painful stimuli, light, or sound, lacks a normal wake-sleep cycle and does not initiate voluntary actions. Coma patients exhi ...

, or

psychosis Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior ...

, particularly in the elderly. "Myxedema" is a synonym with severe hypothyroidism. It was first described in 1888 by “the Committee of the Clinical Society of London appointed in 1883 to consider the subject of myxedema”, as "Delusions and hallucinations occur in nearly half the cases, mainly where the disease is advanced... acute or chronic manias, dementia, or melancholia, with a marked predominance of suspicion and self-accusation." The name "myxedema madness" was proposed in 1949. It is diagnosed through the measurement of thyroid stimulating hormone and treated by application of

L-thyroxine Levothyroxine, also known as -thyroxine, is a manufactured form of the thyroid hormone thyroxine (T4). It is used to treat thyroid hormone deficiency (hypothyroidism), including a severe form known as myxedema coma. It may also be used to tre ...

. With treatment, over 80% of patients achieve complete remission of psychosis. Myxedematous psychosis, more commonly referred to as the myxedema madness is manifested through hypothyroidism which is a condition in where the thyroid gland does not produce enough thyroid hormones, some of the most common symptoms linked with both of these conditions include: Fatigue, Cold intolerance, Menstrual abnormalities, Decreased appetite, Constipation, Hoarse voice, Bradycardia, Non-pitting edema, Facial puffiness, Slow speech, and Delayed relaxation of deep tendon reflex and fatigue. Examplecase report: a 42 year-old women who had suffered from papillary thyroid carcinoma and had a thyroidectomy which ultimately resulted in her developing paranoid delusions and visual/auditory hallucinations whilst undergoing treatment for elective radioactive iodine treatment, according to the report it states that “she had no history of mental illness” and that “the patient was immediately treated with thyroid hormone replacement therapy”

References

* {{refend Symptoms and signs: Endocrinology, nutrition, and metabolism Thyroid disease

See also

References