September 1993

Thyrotoxicosis Presenting With Seizures and Coma in Two Children

Author Affiliations

Department of Pediatrics Regional Hospital of Bolzano via L. Boehler No. 5 39100 Bolzano Italy
Department of Pediatrics Policlinico San Matteo University of Pavia Italy

Am J Dis Child. 1993;147(9):925-927. doi:10.1001/archpedi.1993.02160330015002

Sir.—Thyrotoxicosis is commonly associated with neurological manifestations such as irritability, confusion, and tremor; seizures and coma have been reported in few patients. To our knowledge, only 10 adults1-8 and one child9 presenting with these symptoms have been described in the literature. We describe two children who presented with severe central nervous system involvement with seizures.

Patient Reports.—Patient 1.—A 10-year-old boy was admitted with vomiting, headache, and stupor. He complained of irritability and mild headache 1 month previously. Two days before admission he suffered a minor head trauma that was considered insignificant by the physician consulted. On admission he was drowsy, and remained confused and unable to show coherent verbal communication (score 12 of the Glasgow Coma Scale). On examination, the pupils were dilated but reactive to light; deep tendon reflexes were normal, no extensor plantar response was elicited, neck stiffness was seen, along with Kernig's and

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