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Encephalopathy associated with Hashimoto's thyroiditis: an additional case.

M Bertoni¹, M Falcini, S Sestini

¹Divisione di Medicina Interna, Ospedale di Prato, Piazza Ospedale 1, I-59100, Prato, Italy

European Journal of Internal Medicine

|November 15, 2003

Summary

Hashimoto

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Area of Science:

Neurology
Endocrinology
Immunology

Background:

Hashimoto's thyroiditis (HT) is an autoimmune disease primarily affecting the thyroid gland.
Neurological manifestations of HT, known as Hashimoto's encephalopathy, are rare but can be severe.
Encephalopathy associated with HT can present with diverse neurological symptoms.

Purpose of the Study:

To describe a case of Hashimoto's encephalopathy presenting with unusual neurological symptoms.
To highlight the diagnostic findings using neuroimaging techniques.
To report the effectiveness of corticosteroid treatment.

Main Methods:

Case presentation of a 35-year-old female with Hashimoto's thyroiditis.
Brain magnetic resonance imaging (MRI) to assess structural changes.

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Brain single photon emission computerized tomography (SPECT) to evaluate cerebral blood flow.

Clinical assessment of response to corticosteroid therapy.

Main Results:

The patient exhibited episodic dysphasia, axial jerks, abdominal muscle contraction, and asymmetric blepharospasm.
MRI revealed scattered supratentorial white matter hyperintense T2 foci.
SPECT demonstrated cortical hypoperfusion in the upper frontal and parietal regions.
Corticosteroid therapy led to rapid clinical improvement.

Conclusions:

Hashimoto's encephalopathy can manifest with a unique combination of neurological symptoms.
Neuroimaging findings, including MRI and SPECT, can aid in diagnosis.
Prompt corticosteroid treatment is effective in managing Hashimoto's encephalopathy.