An unusual neurological presentation of thyroid storm: Isolated nystagmus

Thyroid storm (TS) or thyrotoxic crisis is a rare medical emergency that may initially present with various clinical manifestations including nausea, palpitations, and fever. Although quite unusual, TS may also clinically present with neurological manifestations of agitation, delirium and anxiety as well as ophthalmological manifestations, including proptosis and eyelid lag. A detailed literature review of case reports and various studies has reported nystagmus to be an extremely rare initial clinical manifestation of TS. We report a case of a young female, newly diagnosed with hyperthyroidism, who primarily presented with complaints of isolated nystagmus. She was diagnosed with TS and immediately started on medications. Her nystagmus improved once she was treated for TS. In conclusion, nystagmus as a manifestation of TS is an unusual phenomenon but can be reversible with appropriate treatment of the underlying cause.