vmireavizВестник медицинского института «РЕАВИЗ». Реабилитация, Врач и ЗдоровьеBulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH)2226-762X2782-1579РЕАВИЗ10.20340/vmi-rvz.2022.5.CASE.1vmireaviz-509Research ArticleКлинический случайClinical caseТиреотоксический периодический паралич. Клиническое наблюдениеThyrotoxic periodic paralysis. A case reporthttps://orcid.org/0000-0001-6824-4114РамазановГ. Р.RamazanovG. R.

Рамазанов Ганипа Рамазанович - кандидат медицинских наук, заведующий научным отделением неотложной неврологии и восстановительного лечения.

Москва.

Moscow.

ramazanovgr@sklif.mos.ruhttps://orcid.org/0000-0001-9750-3509ШевченкоЕ. В.ShevchenkoE. V.

Шевченко Евгений Владимирович - кандидат медицинских наук, заведующий неврологическим отделением для больных с острыми нарушениями мозгового кровообращения, врач-невролог.

Москва.

Moscow.

shevchenkoev@sklif.mos.ruhttps://orcid.org/0000-0001-8096-5029АхматхановаЛ. Х.-Б.AkhmatkhanovaL. Kh.-B.

Ахматханова Лиана Хаваж-Баудиновна - младший научный сотрудник, врач-невролог неврологического отделения для больных с острыми нарушениями мозгового кровообращения с палатой реанимации и интенсивной терапии.

Москва.

Moscow.

akhmatkhanovalb@sklif.mos.ruhttps://orcid.org/0000-0003-3292-8789ПетриковС. С.PetrikovS. S.

Петриков Сергей Сергеевич - доктор медицинских наук, член-корреспондент РАН, профессор, директор НИИ скорой помощи им. Н.В. Склифосовского.

Москва.

Moscow.

petrikovss@sklif.mos.ruНаучно-исследовательский институт скорой помощи им. Н.В. СклифосовскогоРоссияSklifosovsky Clinical and Research Institute for Emergency MedicineRussian Federation202206092022058287Copyright © Рамазанов Г.Р., Шевченко Е.В., Ахматханова Л.Х., Петриков С.С., 20222022Рамазанов Г.Р., Шевченко Е.В., Ахматханова Л.Х., Петриков С.С.Ramazanov G.R., Shevchenko E.V., Akhmatkhanova L.K., Petrikov S.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestnik.reaviz.ru/jour/article/view/509

У 19-26 % пациентов, госпитализированных в стационар с подозрением на инсульт, причиной неврологического дефицита являются не цереброваскулярные заболевания. В данной статье на примере пациента с впервые выявленным тиреотоксическим периодическим параличом представлены клинические, лабораторные и инструментальные особенности данного заболевания. Поиск причины периодического паралича позволил выявить эндокринологическое заболевание - диффузный токсический зоб, назначить антитиреоидную терапию. Представлены данные проспективного наблюдения пациента. Рассмотрен дифференциально-диагностический ряд заболеваний с остро возникшим нижним парапарезом, включивший разрыв аневризмы передней соединительной артерии, двусторонний инфаркт в бассейнах передних мозговых артерий, тромбоз верхнего сагиттального синуса, острые нарушения спинального кровообращения и синдром Гийена - Барре. Обоснована необходимость включать в дифференциально-диагностический ряд тиреотоксический периодический паралич у пациентов с остро возникшим нижним парапарезом.

In 19-26% of patients hospitalized with suspected stroke, the cause of neurological symptoms are not cerebrovascular diseases. In this case of newly diagnosed thyrotoxic periodic paralysis we presented the clinical, laboratory and instrumental features of the disease. The search for the cause of periodic paralysis allowed to identify an endocrinological disease - diffuse toxic goiter, prescribe antithyroid therapy. The data of prospective patient observation are presented. We discussed a differential diagnostic range of diseases with acute low paraparesis, including rupture of an aneurysm of the anterior communicating artery, bilateral infarction in territory of anterior cerebral arteries, thrombosis of upper sagittal sinus, acute spinal strokes and Guillain - Barre syndrome. The need to include thyrotoxic periodic paralysis in patients with acute lower paraparesis in the differential diagnostic series is substantiated.

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The authors declare that there are no conflicts of interest present.