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Spindle coma secondary to thyrotoxicosis

H.F. Rubio-Chevannier, R.I. Ramírez-Segura, J. Campos-Castelló, A. Serdio-Carranza, M. Talavera-Torres [REV NEUROL 2002;34:1096-1097] PMID: 12134310 DOI: https://doi.org/10.33588/rn.3411.2001284

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Volumen 34 | Number 11 | Nº of views of the article 6.093 | Nº of PDF downloads 310 | Article publication date 01/06/2002

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ABSTRACT

INTRODUCTION The term “spindle” is used to refer to the bioelectrical semiological element found in the electroencephalographic (EEG) exploration of comatose patients on a rhythm of delta or theta activities, and is different to physiological sleep spindle because the patient is unable to recover a normal level of consciousness. CLINICAL CASE. We report the case of a female patient in a state of drowsiness secondary to thyrotoxicosis, which evolved toward a coma 12 days after the onset of the process. Under medical treatment with propranolol and antithyroid drugs, she regained her initial waking state 30 days after the clinical onset. Discussion. The mechanisms underlying spindle coma (SC), which are different to those found in infectious or hypoxic encephalopathies where the alterations are more diffuse, are more difficult to explain from a neurophysiological point of view. Although the nature of the disorder does not require involved anatomical structures, it could be a consequence of an alteration in the corticothalamic circuits. CONCLUSION: The ascending reticular formation, with its multiple synapses, is more sensitive to metabolic changes and to the action of different drugs than the direct sensorial pathways. KeywordsElectroencephalogram Sleep Spindle Thyrotoxicosis CategoriesNeuropsiquiatría Sueño Trastornos metabólicos y tóxicos

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Comunicaciones breves

Spindle coma secondary to thyrotoxicosis