Simulation of Progressive Muscular Atrophy by Exophthalmic Goiter

That myasthenia, sometimes severe, may be a part of the picture in exophthalmic goiter, has long been known. That marked muscular atrophy may also occur is less widely recognized. For some years we have been interested in localized muscle atrophies seen in certain of our thyrotoxic patients, usually in the temporal or thenar regions, but it was not until two years ago that we encountered a picture simulating that of progressive muscular atrophy, subsequently proved to be due to exophthalmic goiter. The patient in question, a Polander of 48, entered the Neurological Service of the Massachusetts General Hospital (Hospital Number 321056) on May 3, 1932, when a preliminary diagnosis was made by one of us (J. B. A.) of “muscular atrophy associated with chronic systemic disease.” The story was that of progressive weakness and wasting, together with marked muscular twitchings, all of which had begun after a “cold” seven weeks before. There had been a coincident weight loss of 24 pounds.