Thyroid storm is a life-threatening endocrine emergency. A substantial proportion of patients develop acute central nervous system disturbances — from agitation and psychosis to convulsions and loss of consciousness — which often require urgent, targeted management alongside the thyroid crisis itself.
Clinical scenario
This protocol addresses thyroid storm in patients presenting with one or more of the following CNS manifestations:
Restlessness
Delirium
Psychosis
Agitation
Convulsion
Somnolence
Coma
Treatment approach — partial overview
Management addresses two parallel presentations. For restlessness, delirium, and psychosis, the choice of agent class depends on whether the patient can tolerate oral medication — antipsychotic therapy is central to this pathway, with distinct first-line options for each route. For convulsions, a separate first-line drug class is indicated for acute management.
The complete protocol — full agent selection, route, sequencing, monitoring, and all clinical contingencies — is available in the structured regimen below.