Thyroid storm
ICD-10 E05.5 · ICD-11 5A02.5

Thyroid Storm with Persistent CNS Manifestations After First-Line Treatment

Thyroid storm can present with severe central nervous system involvement — restlessness, delirium, psychosis, agitation, convulsions, somnolence, or coma. When these features do not resolve with initial management, an escalated protocol is indicated.

Clinical Scenario

Thyroid storm often presents with CNS manifestations such as restlessness, delirium, psychosis, somnolence, convulsion, and coma. This protocol addresses patients in whom those features persist despite first-line therapy.

After First-Line Treatment

Goals not met

The preceding treatment step targeted control of restlessness, delirium, and psychosis using antipsychotic medication (oral or injectable), and cessation of convulsions using benzodiazepine (diazepam) intravenously as the first-line anticonvulsant agent.

When those goals — control of CNS agitation, delirium, and psychosis, and cessation of convulsions — are not achieved, this next-line protocol applies.

Next-Line Approach (Partial Overview)

For refractory convulsions that have not responded to first-line anticonvulsant therapy, an additional class of anticonvulsant medication may be indicated. The clinical goal is cessation of convulsions.

The specific agents, selection criteria, and complete management algorithm are available in the full protocol.

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References

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