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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
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.
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.
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.