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Neurologic manifestations of hypothyroidism

Devon I Rubin, MD
Section Editors
Michael J Aminoff, MD, DSc
Douglas S Ross, MD
Deputy Editor
Janet L Wilterdink, MD


Hypothyroidism is a common medical condition in the general population. Common systemic manifestations include fatigue, constipation, cold intolerance, weight gain, hair loss, dry skin, and hoarseness. A variety of central and peripheral nervous system manifestations are common in patients with hypothyroidism (table 1). In many cases, the neurologic manifestations occur in conjunction with the systemic features of the disease and may be noted only incidentally. However, symptoms and signs of neurologic dysfunction may be the presenting feature in some patients and can contribute significant disability. Most of these complications are partially or fully responsive to thyroid replacement.

This topic reviews the common neurologic manifestations of hypothyroidism. Other clinical manifestations of hypothyroidism are discussed separately. (See "Clinical manifestations of hypothyroidism".)


Fetal and/or neonatal hypothyroidism causes neurologic sequelae, including impaired intellectual and motor development. The severity of the impairment depends upon the severity and duration of fetal/neonatal hypothyroidism. Although the effects of postnatal hypothyroidism can be ameliorated by prompt treatment, the sequelae of gestational hypothyroidism, particularly in the first trimester, persist throughout life. One cause of hypothyroidism in neonates is maternal and infant iodine deficiency, which is still endemic in some parts of Europe and elsewhere in the world.

Neurologic sequelae include:

Intellectual disability – The severity of cognitive impairments is associated with both the degree and duration of thyroid (or iodine) deficiency in utero and early life [1]. Severe deficiency in the first trimester of pregnancy in particular is associated with severe irreversible intellectual as well as motor impairment [2,3].

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Literature review current through: Dec 2017. | This topic last updated: Oct 18, 2017.
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