Past Issues

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.