Purpose of Review

Endocrine disorders are the result of insufficient or excessive hormonal production. The clinical course is long, and the manifestations are nonspecific due to the systemic effect of hormones across many organs and systems including the nervous system. This is a narrative review of the recent evidence of the diagnosis and treatment approach of these medical and neurological emergencies.

Recent Findings

With the possible exception of diabetic ketoacidosis, hyperosmolar hyperglycemic state, and hypoglycemia, endocrinological emergencies are complex, uncommon yet life-threatening conditions with protean and often nonspecific early clinical signs. They frequently are the first manifestation of the endocrine derangement. The systemic effects of hormones extend to the nervous system and as such, these conditions can present with neurological complications manifested, in most cases, by a diffuse dysfunction of the brain in the form of encephalopathy, delirium, seizures, and coma; or specific and peculiar syndromes such as hemichorea, hemiballism, and epilepsia partialis continua. The severity of these conditions often necessitates management in the intensive care unit requiring substantial supportive care in addition to specific targeted therapy to correct the hormonal metabolic abnormalities while at the same time blocking hormonal activity, in cases of excessive function, or supplementing hormonal deficiencies.

Summary

Endocrine emergencies and their neurological complications are infrequent. The major challenge for most is early recognition. Their morbidity and mortality are high and their diagnosis requires high index of suspicion. The neurological complication most often improves with the correction of the metabolic derangement and their acuity and severity require admission to the intensive care unit.

中文翻译：

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内分泌紧急情况的神经系统并发症

审查目的

内分泌失调是激素分泌不足或过多的结果。临床过程很长，并且由于激素在包括神经系统在内的许多器官和系统中的全身作用，其表现是非特异性的。这是对这些医学和神经系统紧急情况的诊断和治疗方法的最新证据的叙述性综述。

最近的发现

除糖尿病性酮症酸中毒，高渗性高血糖状态和低血糖症外，内分泌急症是复杂的，罕见的但危及生命的疾病，有蛋白质和通常是非特异性的早期临床体征。它们经常是内分泌失调的第一个表现。激素的全身作用扩展到神经系统，因此，这些病症可伴有神经系统并发症，在大多数情况下，表现为脑病，del妄，癫痫发作和昏迷等形式的脑弥漫性功能障碍。或特定和特殊的综合症，例如半球菌病，半球症和部分性癫痫持续。

概括

内分泌急症及其神经系统并发症很少见。大多数人面临的主要挑战是及早识别。他们的发病率和死亡率很高，诊断需要高度怀疑的指标。神经系统并发症通常会随着代谢紊乱的纠正而改善，并且其敏锐度和严重性需要进入重症监护病房。