Amnesic syndrome with bilateral mesial temporal lobe involvement in Hashimoto's encephalopathy.
A 25-year-old woman presented with a subacute confusional state, headaches, unsteadiness, myoclonus, seizures, and an amnesic syndrome as a manifestation of Hashimoto's encephalopathy. Investigations showed biochemical hypothyroidism, raised thyroid microsomal antibodies, and weakly positive antineuronal antibodies. A T2-weighted MRI of the brain showed bilateral symmetric areas of increased signal in the mesial temporal lobes and hippocampi that had a low signal intensity on T1-weighted imaging. Despite clinical and radiologic improvement after steroid and thyroid hormone replacement therapy, a severe amnesic syndrome with associated localized MRI abnormalities persists.
McCabe
D J
DJ
Department of Neurology, St. Vincent's Hospital, Elm Park, Dublin, Ireland. d.mccabe@ion.ucl.ac.uk
Burke
T
T
Connolly
S
S
Hutchinson
M
M
D000328:Adult; D000647:Amnesia / Q000473:pathology*; D001921:Brain / Q000473:pathology; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008279:Magnetic Resonance Imaging; D013702:Temporal Lobe / Q000473:pathology*; D013967:Thyroiditis, Autoimmune / Q000473:pathology*