{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:07:02Z","timestamp":1756339622415,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,11,26]]},"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:p>Neurological manifestations of hypothyroidism include peripheral neuropathy and pituitary hyperplasia. However, these associations are rarely encountered during pregnancy. We report a case of a known hypothyroid with very high thyroid stimulating hormone (TSH) values (512 \u03bcIU\/mL) in the second trimester. At 24 weeks she developed facial palsy and pituitary hyperplasia which responded to a combination of steroids and thyroxine. She had caesarean delivery at 35 weeks and 3 days gestation in view of pre-eclampsia with severe features and was discharged on oral antihypertensives and thyroxine. On follow-up at 5\u2009months, TSH normalised and pituitary hyperplasia showed a greater than 50% reduction in size. To our knowledge, this is the first reported case of facial palsy and pituitary hyperplasia associated with hypothyroidism during pregnancy.<\/jats:p>","DOI":"10.1136\/bcr-2020-238069","type":"journal-article","created":{"date-parts":[[2020,12,28]],"date-time":"2020-12-28T12:22:30Z","timestamp":1609158150000},"page":"e238069","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Neurological manifestation in severe hypothyroidism in pregnancy"],"prefix":"10.1136","volume":"13","author":[{"given":"Aparna","family":"Sharma","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8588-7928","authenticated-orcid":false,"given":"Nilofar","family":"Noor","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vatsla","family":"Dadhwal","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,12,28]]},"reference":[{"key":"2025082712294634000_13.12.e238069.1","doi-asserted-by":"crossref","DOI":"10.7717\/peerj.52","article-title":"Hypothyroidism and diabetes mellitus - a risky dual gestational endocrinopathy","volume":"1","author":"Tirosh","year":"2013","journal-title":"PeerJ"},{"key":"2025082712294634000_13.12.e238069.2","doi-asserted-by":"crossref","first-page":"13","DOI":"10.4103\/ijem.IJEM_189_17","article-title":"Prevalence of hypothyroidism in term pregnancies in North India","volume":"22","author":"Kalra","year":"2018","journal-title":"Indian J Endocrinol Metab"},{"key":"2025082712294634000_13.12.e238069.3","doi-asserted-by":"crossref","first-page":"1586","DOI":"10.18203\/2320-1770.ijrcog20181360","article-title":"Prevalence of hypothyroidism amongst pregnant women: a study done in rural set up","volume":"7","author":"Pillai","year":"2018","journal-title":"Int J Reprod Contracept Obstet Gynecol"},{"key":"2025082712294634000_13.12.e238069.4","doi-asserted-by":"crossref","first-page":"387","DOI":"10.4103\/2230-8210.179992","article-title":"Prevalence of hypothyroidism in pregnancy: an epidemiological study from 11 cities in 9 states of India","volume":"20","author":"Dhanwal","year":"2016","journal-title":"Indian J Endocrinol Metab"},{"key":"2025082712294634000_13.12.e238069.5","unstructured":"Saraladevi R , Kumari TN , Shreen B , et al . 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