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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
PubMed
Summary

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.

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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.