Hashimoto's encephalopathy: a steroid-responsive disorder associated with high anti-thyroid antibody titers--report of 5 cases.
We describe 5 patients with a relapsing encephalopathy in association with Hashimoto's disease and high titers of anti-thyroid antibodies. The presentation is usually with a subacute onset of confusion, alteration in conscious level, and focal or generalized seizures. The relapsing course, association with myoclonus or tremulousness, and episodes of stroke-like deterioration are characteristic features. The long-term prognosis is favorable with steroid therapy, though additional immunosuppressive therapy may be required. Neurologic investigation typically shows a diffusely abnormal EEG, high CSF protein level without pleocytosis, and normal brain CT and cerebral angiogram. Isotope brain scan may show patchy abnormal uptake. Hashimoto's encephalopathy should be recognized as a definite neurologic entity and added to the list of CNS complications of thyroid disease.
Shaw
P J
PJ
Department of Neurology, University of Newcastle upon Tyne, UK.
Walls
T J
TJ
Newman
P K
PK
Cleland
P G
PG
Cartlidge
N E
NE
D000293:Adolescent; D001323:Autoantibodies / Q000032:analysis*; D001927:Brain Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D013256:Steroids / Q000627:therapeutic use*; D013961:Thyroid Gland / Q000276:immunology*; D013967:Thyroiditis, Autoimmune / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D014057:Tomography, X-Ray Computed
D001323:Autoantibodies; D013256:Steroids