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.
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Over the proceeding 2 months she had lost the nails of her right hand and had lesions on her back and face compatible with excoriation. The presence of antithyroglobulin antibody Ac-anti-Tg was not detected.
Alopecia is associated with polyglandular autoimmunity. Migraine Df hemiplegic Cluster Tension. CNS involvement is rare in this context, HE being the most common example. Ataxia, low amplitude high frequency action and postural tremors and myoclonus were observed in the four limbs.
InBrain et al. She had three pregnancies with normal gestation, last 9 years ago. Antithyroid antibodies in the CSF: We believe that this pathology is misdiagnosed, therefore, tests detecting the presence of anti-thyroid antibodies are recommended in a clinical presentation of encephalopathy of subacute onset or rapidly progressive dementia associated with myoclonus and triphasic complexes in the EEG, when the ethiology is not identified.
Encephalomyelitis Acute disseminated Myalgic Meningoencephalitis.
Hashimoto’s encephalopathy with clinical features similar to those of Creutzfeldt-Jakob disease
Normotensive, pulse bpm, she had universal alopecia, cyanosis and pale alternating in the extremities, growing nails of the right hand and scars on her back and face. It is recommended to reduce the dose of steroids over several months. CASE A female patient, years-old, Encefaoopatia, widow, born in Rio de Janeiro, developed a clinical presentation of daily sadness, discouragement, decreased appetite, insomnia, and cognitive decline.
Creutzfeldt-Jakob disease has a progressive and inexorably fatal course, as opposed to Hashimoto’s encephalopathy, which has a fluctuating course and excellent response to treatment with corticosteroids.
Clinical manifestations of HE may include encephalopathic features such as seizures, behavioral and psychiatric manifestations, movement disorders, and coma.
The first case of HE was described by Brain et al. Serology, cultures and diagnostic imaging did not indicate an infectious process.
A recent study by Martins et al. Hashimoto’s disease and encephalopathy. It is thought that there is an immune mediated cerebral vasculitis, with or without deposits of immune complexes, or an anti-neuronal mechanism mediated by anti-bodies 8.
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.
She was histrionic with disturbed thought. As mentioned above, autoantibodies to alpha- enolase associated with Hashimoto’s encephalopathy have thus far been the most hypothesized mechanism of injury.
The rest of the physical examination was normal. Onset is often gradual and may go unnoticed enfefalopatia the patient and close associates to the patients. 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, Hashimoto’s encephalitis HEencephalitis which responds to steroids and is associated with auto-immune thyroiditis, was described by Brain et al.
Poliomyelitis Demyelinating disease Transverse myelitis Tropical spastic paraparesis Epidural abscess.
How to cite this article. In this period there was a regression of all signs and symptoms.
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. Because most patients respond to steroids or immunosuppressant treatment, this condition is now also referred to as steroid -responsive encephalopathy.
The most common abnormality is diffuse increased signal in the white substance 2. The clinical manifestations can be fluctuating or persistent, and reversible, if properly treated with immunosuppressive therapy 3.