Weakness occurs in 20% of thyrotoxic patients. Shoulder girdle weakness is more marked than pelvic. Reflexes are brisk, fasciculation and atrophy may be present. Distinction must be made from motor neuron disease. These is always clinical evidence of thyrotoxicosis in these patients. Diagnosis is confirmed by thyroid function studies.
Proximal weakness involves pelvic girdle more than shoulder. Painful cramps and muscle stiffness are common.
Muscle enlargement in limbs and tongue often occur. There is always clinical evidence of hypothyroidism in these patients. Diagnosis is confirmed by thyroid function tests and response to thyroid hormone therapy is excellent.
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