Autoimmune thyroiditis and a rapidly progressive dementia: global hypoperfusion on SPECT scanning suggests a possible mechanism.
We report the clinical, laboratory, EEG, and SPECT findings in a 59-year-old euthyroid woman with previously undiagnosed autoimmune thyroiditis, subclinical hypothyroidism, and rapidly progressive dementia. We made a diagnosis of Hashimoto's encephalopathy based on elevated thyrotropin, abnormal EEG, and clinical improvement after thyroid hormone replacement. SPECT demonstrated global hypoperfusion with normalization on clinical recovery, suggesting a possible mechanism for the pathogenesis of Hashimoto's encephalopathy.
Forchetti
C M
CM
Department of Neurological Sciences, Rush Presbyterian St. Luke's Medical Center, Chicago, IL 60612-3824, USA.
Katsamakis
G
G
Garron
D C
DC
D001921:Brain / Q000000981:diagnostic imaging; D003704:Dementia / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D003937:Diagnosis, Differential; D018450:Disease Progression; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008875:Middle Aged; D013967:Thyroiditis, Autoimmune / Q000150:complications* / Q000175:diagnosis; D015899:Tomography, Emission-Computed, Single-Photon