Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: Thyroid problems and brain damage

Forum: Neurology Forum
Topic: Behavioral Disorders

Hi,
Eight years ago one day my sister fell while getting down from a bus..
there was no external injury, so we never paid any attention to this,
she started behaving abnormally(kind of depressed,refused to talk too
much, eat,would not even brush her teeth). Since she had failed her
exams two-three days back..so we thought she was these were symptoms
of depression and took her to a psychiatrist..she was treated for
depression for roughly two years(till March 1997)..her main symptoms :
she was more aggressive, her menstrual periods had stopped, her hands had
become coarse, put on a lot of weight(even though she never ate much) and
slowly lost the mental maturity that is expected from an adult
(she was 20 when this started).then as her mental state deteriorated,
she was treated for schizophrenia for three or four years but without much
success.she never really responded to any of the medicines etc..on the
contrary, somewhere down the line, I started to have difficulty in
understanding her words as they were sort of slurred.
.her body responses/reflexes were extremely slow(you could see the time it
took her to lift a glass of water).
She used to be thursty all the time, could not bear cold, had constant
constipation lasting a week or so. Finally in 1997 a "thyroid test"
revealed that she had extreme thyroid deficiency all this while. She
improved drastically with the thyroid treatment and all her symptoms
disappeared, except for one. Though her mental state returned almost to
normal,I still donot see her regaining a normal level of
intelligence/maturity expected from a person who is 28 years old.
Sometimes she also talks irrelevant. We are confused if she actually has
a mental problem or it was just the effect of "thyroid" deficiency? Also is it
possible to restore the damage in the brain(if any) that would have been
caused by the "thyroid" problem? What all tests should be done on her to
identify if there is a physical damage to the brain. On second thoughts,
could the actual accident I mentioned earlier have anything to do with her mental
problems?Any advices on what to do?

Dear Anjana,
thank you for the question.
It is unclear to me if your sister was doing fine, everthing was normal until after the trauma, or has she been kind of slow, both mentally and motor reaction that just got worse slowly. Profound longstanding hypothyroidism can cause cerebral dysfunction. All of the things you mentioned fit the classic description of hypothyroidism. It is rather sad that it went undiagnosed for so many years. At any rate your sister is doing much better now, I am very glad to hear that. One thing we can do is to do a complete neuropsychological evaluation ( a long test) that asseses her memory, concentration, naming ability, orientation, knowledge, abstract thinking,
judgement, planning, etc. It can identify if the deficits are confined to specific areas of cognitive function. This may help sort things out.
The test is given by neuropsychologist. She should be evaluated by a good behavioral neurologist. I hope the above information helps.
Thyroid disease (both hypo and hyper) can cause a variety of neurologic symptoms and by enlarge treatable. So it is always advisable to check thyroid function test. If you have further information or questions please don't hesitate to post a follow up.
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