Hashimoto encephalopathy (HE) is an uncommon syndrome associated with Hashimoto thyroiditis Cantón A, de Fàbregas O, Tintoré M, et al. Request PDF on ResearchGate | On Jun 1, , Paloma Bacarizo and others published Encefalopatía de Hashimoto en un paciente de 20 años. CLINICAL/SCIENTIFIC NOTE. Hashimoto’s encephalopathy. Encefalite de Hashimoto. Renata Telles Rudge de AquinoI; Eduardo Genaro MutarelliII.

Author: Keshura Gusar
Country: Bahrain
Language: English (Spanish)
Genre: Environment
Published (Last): 10 October 2010
Pages: 126
PDF File Size: 2.54 Mb
ePub File Size: 13.76 Mb
ISBN: 314-2-75011-743-6
Downloads: 20406
Price: Free* [*Free Regsitration Required]
Uploader: Vikree

The magnetic resonance imaging MRI of the brain showed small changes that were not significant, such as the presence of hypersignal focus in the corona radiata and bilaterally semioval center Fig 1. Brain Encephalitis Viral encephalitis Herpesviral encephalitis Limbic encephalitis Encephalitis lethargica Cavernous sinus thrombosis Brain abscess Amoebic. Since then, Hashimoto’s encephalopathy has been recognized as a rare condition associated to Hashimoto’s thyroiditis and to the presence of high concentrations of antithyroid antibodies, unlike those described in myxedema and in thyrotoxicosis 2.

Hashimoto’s encephalopathy

J Clin Endocrinol Metab ; Received 6 Novemberreceived in final form 30 March HE occur predominantly in women 4: However, the final diagnosis is obtained through a hahsimoto exam 9. Because most patients respond to steroids or immunosuppressant treatment, this condition is now also referred to as steroid -responsive encephalopathy.

The rest of the physical examination was normal. Anti-thyroperoxidase antibodies anti-TPO was 1. Two clinical forms have been described: Like other autoimmune disease improvement may occur spontaneously 4. Japan, and Depannient of Anatomy and Biology.

Hashimoto’s encephalopathyalso known as steroid responsive encephalopathy associated with autoimmune thyroiditis SREATis a neurological condition characterized by encephalopathythyroid autoimmunity, and good clinical response to steroids.

Hashimoto’s encephalopathy is a rare condition associated with Hashimoto thyroiditis, the presence of high concentrations of anti-thyroid antibodies, without any evidence of thyroid dysfunction, and an excellent response to treatment with corticosteroids 2.

Fe had a 2 years history of feeling progressively tired, insomnia, cramps, tremors, arthralgia, paraethesia in her hands and back pain.


Consistent with this hypothesis, autoantibodies to alpha-enolase have been found to be associated with Hashimoto’s encephalopathy. She was stable, suggesting a hypothalamic dysfunction. Antithyroid antibodies in the CSF: Besides behavioral problems and cognitive decline, there may be fluctuating symptoms, tremor, transitory aphasia, myoclonus, ataxia, convulsions, sleep abnormalities, motor or sensory deficits and psychosis.

The symptoms were recurrent and reversible and were not associated with thyroid dysfunction 1. Isolated angiitis of the CNS associated with Hashimoto’s disease.

Hashimoto’s encephalopathy – Wikipedia

InBrain et al. Serology, cultures and diagnostic imaging did not indicate an infectious process. The condition of the patient worsened with persecutory delusions, visual hallucinations, gait disturbance, tremor of the extremities, muscle spasms, and fluctuations in the level of consciousness.

She has universal alopecia which started when she was Hashimoto’s encephalitis as a differential diagnosis of Creutzfeldt-Jakob disease.

The responsiveness of HE to steroids or other therapies such as plasmapheresis supports the hypothesis that this is a disorder that involves immune pathogenic mechanisms. It is sometimes referred to as a neuroendocrine disorder, although the condition’s relationship to the endocrine system is widely disputed.

Brain herniation Reye’s Hepatic encephalopathy Toxic encephalopathy Hashimoto’s encephalopathy. There was a reduction in anti-TPO which co-related with the clinical picture.

Alopecia is associated with polyglandular autoimmunity. There followed a period of three years with difficulties at school. She had three pregnancies with normal gestation, last 9 years ago. Although it has been linked to cases of Hashimoto’s thyroiditis or thyroid dysfunction, the most common immunological feature of HE is the presence of high titers of antithyroglobulin or anti-TPO antimicrosomal antibodies. Some patients need to stay on low doses or a new course of high dose of prednisolone is necessary 2.

The presence rapidly progressive dementia, ataxia, myoclonus, and especially the presence of triphasic complexes in the EEG, make the diagnosis a probable one for Creutzfeldt-Jakob disease. Prominent triphasic waves, focal slowing, epileptiform abnormalities, photoparoxysmal and photomyogenic responses may be seen. By using this site, you agree to the Terms of Use and Privacy Policy.


It is a diagnosis of exclusion in a clinical picture of encephalitis with negative investigations 2,4,7,9. It presents with acute or sub-acute encephalopathy, tremor, myoclonus, ataxia, fits, psychosis or stroke like events, progressive or relapsing, high titres of anti-thyroid antibodies but independent of thyroid function 2,4, Post-mortem studies of some individuals have shown lymphocytic vasculitis of venules and veins in the brain-stem and a diffuse gliosis involving gray matter more than white matter.

Steroid-responsive encephalopathy associated with autoimmune thyroiditis. It is probably under diagnosed as it is not well known 5. High titres of anti-TPO are common markers of an auto-immune process but it is unlikely that they have a pathogenic role 9.

Hashimoto’s encephalopathy.

Hashimoto’s encephalopathy with clinical features similar to those of Creutzfeldt-Jakob disease. The patients met the clinical criteria for Creutzfeldt-Jakob disease and were notified 8. Eight years ago she developed hypothyroidism due to Hashimoto’s thyroiditis, and has been taking mcg levothyroxine daily.

Hashimoto’s disease encefalopatka encephalopathy. A relapsing encephalopathy occurring in association with Hashimoto’s thyroiditiswith high titers of anti-thyroid antibodies. Clinically, the condition may present one or more symptoms.

Hashimoto’s encephalopathy HE is a controversial neurological disorder that comprises a heterogenous group of neurological symptoms that manifest in patients with high titers of antithyroid antibodies.

In this period there was a regression of all signs and symptoms. In some cases, Hashimoto’s encephalopathy can show rapidly progressive dementia, myoclonus, and electroencephalographic changes with periodic recurrence of the triphasic complexes similar hashijoto those of Creutzfeldt-Jakob disease, which makes a differential diagnosis essential to both pathologies 4. She was maintained on oral prednisolone.

Duration of treatment is hashimtoo between 2 and 25 years. Rarity of encephalopathy associated with autoimmune thyroiditis: