Gülten Özdemir
Istanbul Eah Hospital, Turkey
Title: A case of thyroid hemiagenesis diagnosed after essential tremor symptoms
Biography
Biography: Gülten Özdemir
Abstract
Background: Essential tremor (ET) is a neurological disorder causing involuntary rhythmic tremors (4–12 Hz) and mostly
seen in adults of age 40 or more. ET is a clinical diagnosis and is commonly seen ipsilaterally, worsens with movement and
usually hands are involved initially. Physical and emotional stress, fatigue, low blood glucose level, alterations in temperature,
caffeinated drinks may trigger the condition. ET is not a life threatening condition but if the symptoms are severe, it may affect
the quality of life. Thyriod hormone is mainly required for growth and the development of organs including brain and skeletal
systems. Thyroid hemiagenesis (TH) is a rare, congenital disorder characterized by non-development of a lobe of the thyroid
gland.
Case: A 23 year old female patient having bilateral tremor for approximately 10 years, intensifying with motion presented to
the neurology outpatient clinic for the very first time. Muscle tone and strength, deep tendon reflexes, sensual examination,
posture, balance and coordination and walking were evaluated as part of the usual neurological examination. Routine
biochemistry, hemogram and thyroid function tests were performed and found as normal, except vitamin B12 deficiency
(176). Known disease, past surgery, exposure to heavy metals and drug use were not present in patient’s history. The patient
lacks history of alcohol and smoking; caffeine use was limited to 1–2 cups of tea/day. The patient had no family history of
essential tremor or Parkinson’s disease. The patient had strain while performing activities such as drinking water from a glass
and drawing circles. Tremor was leading to difficulty in daily life activities and functional loss. Thyroid gland ultrasonography
was performed for advanced study to enlighten essential tremor etiology: agenesis was discovered in thyroid left lobe and the
size of the right lobe was 22*12 mm.
Conclusion: This case was presented due to the lack of similar case in literature. The patient was examined for increased
essential tremor, and hemigenesis in thyroid gland was detected. Female gender and thyroid left lobe agenesis were coherent
with literature for TH. Even though no failure was found in thyroid function tests, it may have an association in cellular level
triggering essential tremor. Further studies are needed to investigate the relation between two diseaeses.