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Neurological manifestation in severe hypothyroidism in pregnancy
  1. Aparna Sharma,
  2. Nilofar Noor and
  3. Vatsla Dadhwal
  1. Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, Delhi, India
  1. Correspondence to Dr Nilofar Noor; nilofar.noor{at}


Neurological manifestations of hypothyroidism include peripheral neuropathy and pituitary hyperplasia. However, these associations are rarely encountered during pregnancy. We report a case of a known hypothyroid with very high thyroid stimulating hormone (TSH) values (512 μIU/mL) in the second trimester. At 24 weeks she developed facial palsy and pituitary hyperplasia which responded to a combination of steroids and thyroxine. She had caesarean delivery at 35 weeks and 3 days gestation in view of pre-eclampsia with severe features and was discharged on oral antihypertensives and thyroxine. On follow-up at 5 months, TSH normalised and pituitary hyperplasia showed a greater than 50% reduction in size. To our knowledge, this is the first reported case of facial palsy and pituitary hyperplasia associated with hypothyroidism during pregnancy.

  • thyroid disease
  • pituitary disorders
  • cranial nerves
  • pregnancy

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  • Contributors All the authors made a substantial contribution to conception and design of manuscript. Acquisition, interpretation and analysis of data and drafting of manuscript was done by NN. It was critically revised by AS and VD. Final approval was done by all the authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.