Thyroid storm is a malignant presentation of hyperthyroidism which has a mortality rate of 10% to 30% around the world. Lack
of direct laboratory test has made the diagnosis of thyroid storm a challenge in clinical practice. There is no consensus about
the diagnosis of thyroid storm and the clinical view, which experience of the practitioner is vital for proper diagnosis of this
situation. Early diagnosis may lead to fast initiation of aggressive treatment to prevent mortality. In this report, we present a case of
thyroid storm which was first approached based on her gastrointestinal (GI) symptoms and re-visited in our center because of no
improvement in her GI symptoms and also addition of CNS manifestations.