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Hashimoto encephalopathy responding to risperidone.

Zia Bismilla1, Erick Sell, Elizabeth Donner

  • 1Department of Pediatrics, Division of Pediatric Medicine, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada. zia.bismilla@sickkids.ca

Journal of Child Neurology
|August 24, 2007
PubMed
Summary
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This case study details an 11-year-old girl with Hashimoto encephalopathy, a rare autoimmune thyroid disorder. Her psychosis responded well to antipsychotic therapy, suggesting a new treatment avenue for pediatric patients.

Area of Science:

  • Neurology
  • Endocrinology
  • Immunology

Background:

  • Hashimoto encephalopathy (HE) is a rare autoimmune neurological disorder associated with autoimmune thyroid disease.
  • It typically presents with encephalopathy, seizures, and neuropsychiatric symptoms.

Observation:

  • An 11-year-old girl presented with encephalopathy, seizures, and neuropsychiatric symptoms suggestive of HE.
  • Diagnostic findings included elevated thyroid-stimulating hormone, low levothyroxine, and positive antithyroperoxidase antibodies.

Findings:

  • Standard levothyroxine treatment was insufficient, necessitating additional valproic acid and methylprednisone.
  • The patient developed acute psychosis, which resolved with risperidone treatment.
  • This is the first reported case of successful antipsychotic therapy for psychosis in a pediatric patient with HE.

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Implications:

  • This case suggests antipsychotic medications may be beneficial for managing psychosis in pediatric HE.
  • Highlights the need for updated management guidelines for this rare condition.
  • Emphasizes the complex interplay between autoimmune thyroid disease and neurological manifestations.