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Cerebellar Syndrome Associated with Thyroid Disorders.

Tommaso Ercoli1, Giovanni Defazio2, Antonella Muroni2

  • 1Department of Medical Sciences and Public Health, Institute of Neurology, University of Cagliari and AOU Cagliari, 09042, Cagliari, Italy. ercolitommaso@me.com.

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Thyroid disorders commonly cause cerebellar dysfunction. This review highlights ataxia in hypothyroidism and Hashimoto encephalopathy, emphasizing treatable neurological symptoms and the need for clinical awareness.

Keywords:
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Area of Science:

  • Neurology
  • Endocrinology

Background:

  • Thyroid disorders are a frequent cause of hormonal imbalance leading to cerebellar dysfunction.
  • Cerebellar impairment is particularly noted in hypothyroidism and Hashimoto encephalopathy.
  • Limited data exists on the clinical and laboratory features of thyroid-associated cerebellar disease.

Purpose of the Study:

  • To review and synthesize information on demographic, clinical, and laboratory features of cerebellar dysfunction in thyroid disorders.
  • To analyze the presentation and outcomes of ataxia in hypothyroidism and Hashimoto encephalopathy.
  • To increase clinician awareness of treatable thyroid-associated ataxia.

Main Methods:

  • Literature review of cases from 1965 to 2018.
  • Analysis of 28 cases of hypothyroidism-associated cerebellar dysfunction.
  • Analysis of 37 cases of Hashimoto encephalopathy-associated cerebellar dysfunction.

Main Results:

  • Ataxia was a common symptom in both hypothyroidism and Hashimoto encephalopathy, often indicating vermis and cerebellar hemisphere involvement.
  • Additional neurological signs like dystonia and psychiatric symptoms were observed in Hashimoto encephalopathy.
  • Cerebellar atrophy was a key imaging finding; anti-thyroid antibodies were prevalent.
  • Thyroid replacement therapy improved ataxia in hypothyroidism; immunosuppressive treatment was effective in Hashimoto encephalopathy.

Conclusions:

  • Cerebellar syndrome associated with thyroid disorders is a significant and treatable clinical entity.
  • Increased awareness among clinicians is crucial for timely diagnosis and management.
  • Effective treatments are available for both hypothyroidism and Hashimoto encephalopathy-related ataxia.