title: Non-convulsive status epilepticus of frontal origin as the first manifestation of Hashimoto's encephalopathy.
abstract: Hashimoto's encephalopathy is an often misdiagnosed, life threatening, condition which improves promptly with steroid therapy. Since clinical manifestations are heterogeneous and non-specific, the diagnosis is often difficult. Several case reports of Hashimoto's encephalopathy presenting with partial or generalised seizures are described, but only a few have focused on status epilepticus as the first clinical manifestation. We report two patients presenting with repetitive and prolonged seizures characterised by progressive reduction in contact and reactivity associated with frontal/diffuse polyspike-and-wave activities. This condition, which can be interpreted as a form of non-convulsive status epilepticus (NCSE) of frontal origin, was refractory to antiepileptic drugs but responded promptly to high doses of intravenous steroid treatment. In cases of unexplained encephalopathy with EEG documentation of NCSE, the early recognition and treatment of Hashimoto's encephalopathy may lead to a favourable prognosis. [Published with video sequences].
authors: Department of Neurosciences, University of Modena and Reggio Emilia, Modena, Italy.
authors: Giulia
authors: G
authors: Monti
authors: Matteo
authors: M
authors: Pugnaghi
authors: Alessandra
authors: A
authors: Ariatti
authors: Laura
authors: L
authors: Mirandola
authors: Giada
authors: G
authors: Giovannini
authors: Silvia
authors: S
authors: Scacchetti
authors: Paolo
authors: P
authors: Nichelli
authors: Stefano
authors: S
authors: Meletti
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D001927:Brain Diseases / Q000150:complications* / Q000188:drug therapy; D002389:Catatonia / Q000209:etiology; D018450:Disease Progression; D004569:Electroencephalography; D004660:Encephalitis; D005260:Female; D050031:Hashimoto Disease / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D013226:Status Epilepticus / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D013256:Steroids / Q000008:administration & dosage / Q000627:therapeutic use; D013960:Thyroid Function Tests
chemical_list: D000893:Anti-Inflammatory Agents; D000927:Anticonvulsants; D013256:Steroids