Hypothyroidism is a leading and the most common thyroid disorder arising from hormonal deficiency. The clinical manifestation of hypothyroidism as a cardiovascular and metabolic complication is well established. However, multiple cranial neuropathy is a rare and uncommon neurological complication of hypothyroidism. The neurological symptoms due to hypothyroidism are multifaceted, which may lead to hampered or delayed diagnosis of the condition.

In this article, we have discussed a case of a patient who developed unusual neurological symptoms due to severe hypothyroidism. A 38-year-old man presented to the ED with a 3-week history of facial weakness (left side) and dysarthria. The patient reported that he underwent surgery for carpal tunnel syndrome on the right hand a few weeks before the presentation of symptoms. The patient experienced a steady increase in body weight of almost 20…