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[Hashimoto encephalopathy. Analysis of four case reports].

F Archambeaud¹, S Galinat, Y Regouby

¹Service de médecine interne B et endocrinologie, hôpital du Cluzeau, 23, avenue D.-Larrey, 87042 Limoges, France.

La Revue De Medecine Interne

|August 18, 2001

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Hashimoto's encephalopathy, a neurological disorder linked to autoimmune thyroiditis, requires consideration for unexplained neuropsychiatric symptoms. Steroid therapy shows promise for favorable outcomes in these cases.

Area of Science:

Neurology
Endocrinology
Immunology

Background:

Hashimoto's thyroiditis is an autoimmune disease associated with encephalopathy, a condition potentially underestimated in clinical practice.
The condition involves neurological or psychiatric manifestations in patients with Hashimoto's thyroiditis.

Observation:

Four patients (3 female, 1 male, mean age 68) presented with diverse neurological symptoms like seizures, psychosis, and altered consciousness.
Standard neurological investigations (EEG, CT, MRI) were non-specific, but CSF analysis revealed elevated protein without pleocytosis.
Patients exhibited mild hypothyroidism with elevated antithyroperoxidase antibodies.

Findings:

Neurological symptoms persisted despite hormone replacement therapy.
A favorable outcome was observed in all patients following steroid treatment.

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Implications:

Hashimoto's encephalopathy should be considered in patients with unexplained neuropsychiatric symptoms.
The efficacy of steroids suggests autoimmune cerebral vasculitis may be involved in the pathogenesis.
Further research into the pathogenic mechanisms of Hashimoto's encephalopathy is warranted.