title: Hashimoto encephalopathy in a 15-year-old-girl: EEG findings and follow-up.
abstract: Hashimoto encephalopathy is characterized by severe neuropsychiatric findings, including psychosis, confusion, seizures, stupor, stroke-like episodes, tremor, and myoclonus. The combination of findings is variable. Hashimoto encephalopathy constitutes an important differential diagnosis in patients with encephalopathy. The triad of encephalopathy, corresponding electroencephalographic slowing, and increased protein content in cerebrospinal fluid should prompt testing of anti-thyroid antibodies in blood and cerebrospinal fluid. Elevated antibody levels support the diagnosis. We describe a 15-year-old girl with a fluctuating course of Hashimoto encephalopathy. Electroencephalograms revealed no specific alterations, but widespread slowing of the background activity occurred during two episodes of fluctuating encephalopathy. Cortical edema was indicated by cranial magnetic resonance imaging during the first episode of encephalopathy, in the context of cerebral seizures. Laboratory findings were in accordance with Hashimoto encephalopathy, which was steroid-responsive.
authors.affiliation: Department of Neuropediatrics, University Medical Center Schleswig-Holstein, Christian Albrechts-Universität zu Kiel, 24105 Kiel, Germany. muhle@pedneuro.uni-kiel.de
authors.forename: Hiltrud
authors.initials: H
authors.lastname: Muhle
authors.forename: Andreas
authors.initials: A
authors.lastname: van Baalen
authors.forename: Felix G
authors.initials: FG
authors.lastname: Riepe
authors.forename: Axel
authors.initials: A
authors.lastname: Rohr
authors.forename: Ulrich
authors.initials: U
authors.lastname: Stephani
mesh_terms: D000293:Adolescent; D001921:Brain / Q000473:pathology / Q000503:physiopathology*; D001927:Brain Diseases / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology*; D001929:Brain Edema; D003937:Diagnosis, Differential; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging