Thyroid disease may be dramatically noticeable or may lurk slowly. The symptoms that can be confused with depression and dementia are_ _ _ .
Elderly patients,
particularly those with toxic nodular goiter, may present
atypically (apathetic or masked hyperthyroidism)
with symptoms akin to depression or dementia.
Most do not have exophthalmos or tremor.
What is likely to be present instead are
- Irregular heart beats [Atrial fibrillation],
- giddiness and fall, [syncope]
- senseless muttering [altered sensorium],
- heart failure, and
- weakness.
Symptoms and signs may involve only a single organ system.
- stare,
- eyelid lag,
- eyelid retraction, and
- mild conjunctival injection
These changes are largely due to excessive adrenergic stimulation. They usually remit with successful treatment.
Infiltrative ophthalmopathy, a more serious development, is specific to Graves' disease, which I do not plan to take up for discussion right away.
Briefly, it is characterized by
- pain around the eye ball socket, [orbital pain]
- tears, [lacrimation] and irritation,
- aversion to light, [photophobia]
- protrusion of eyeball, [exophthalmos]
- weakness of muscles that move the eyes [ocular muscles]
- producing double vision [diplopia],
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