@article {Sharmae238069, author = {Aparna Sharma and Nilofar Noor and Vatsla Dadhwal}, title = {Neurological manifestation in severe hypothyroidism in pregnancy}, volume = {13}, number = {12}, elocation-id = {e238069}, year = {2020}, doi = {10.1136/bcr-2020-238069}, publisher = {BMJ Specialist Journals}, abstract = {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.}, URL = {https://casereports.bmj.com/content/13/12/e238069}, eprint = {https://casereports.bmj.com/content/13/12/e238069.full.pdf}, journal = {BMJ Case Reports CP} }