Skip to content

Advertisement

  • Poster presentation
  • Open Access

Hashimoto encephalopathy: a case report of a mixed type

  • Styliani Spyridi1,
  • Marianthi Arnaoutoglou2,
  • Eugenia Avdelidi2,
  • Eirini Tsirka1,
  • Jannis Nimatoudis1,
  • Stavros Balogiannis2 and
  • George Kaprinis1
Annals of General Psychiatry20087(Suppl 1):S335

https://doi.org/10.1186/1744-859X-7-S1-S335

Published: 17 April 2008

Keywords

ThyroiditisApraxiaNeuropsychiatric SymptomHypothyroid PatientHashimoto Thyroiditis

Background

Hashimoto's thyroiditis is the most common form of thyroiditis. Since first description in 1966, this disorder was associated with encephalopathy, which is unrelated to thyroid's function status. Hashimoto encephalopathy is presented with neurologic or neuropsychiatric symptoms in euthyroid or mildly hypothyroid patients. Although elevated concentrations of antithyroid antibodies are requested for the diagnosis, no correlation between the severity of the syndrome and the antibody levels has been found.

Typically, two types of encephalopathy are described: a stroke-like type, with transient symptoms and focal neurological signs, with or without mental changes and a diffuse, progressive type with cognitive impairment, seizures and psychotic symptoms. Although most of reported cases of this rare syndrome are presented with the specific manifestations of each subtype, these two subtypes may rarely overlap, particularly in the long-term course.

The objective of this report was to describe a case of encephalopathy associated with thyroiditis Hashimoto, initially manifested with clinical symptoms of both subtypes.

Materials and methods

A female 55-year-old patient with history of Hashimoto thyroiditis, hypertension and hyperlipidemia, revealed transient episodes of few minutes duration each, with dystonic phenomena from facial and upper limbs muscles. In the same period, the patient developed a progressive speech and gait apraxia, mental and movement retardation and also a global cognitive impairment. The patient underwent clinical, laboratory, radiological and neuropsychological examination.

Results

The results of the laboratory tests and the neuropsychological profile are discussed.

Conclusions

Although Hashimoto encephalopathy is a rare clinical syndrome, it should be considered in the differential diagnosis of cases of Hashimoto's thyroiditis that develop neurological or neuropsychiatric symptoms, even if the thyroid function is normal.

Authors’ Affiliations

(1)
3rd Psychiatric Department, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
(2)
1st Neurologic Department, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece

References

  1. Sanchez Contreras A, Rojas SA, Manosalva A: Hashimoto Encephalopathy (Autoimmune Encephalitis). J Clin Rheumatol. 2004, 10 (6): 339-343. 10.1097/01.rhu.0000147055.27513.f8.View ArticlePubMedGoogle Scholar
  2. Tamagno G, Federspil G, Murialdo G: Clinical and diagnostic aspects of encephalopathy associated with autoimmune thyroid disease (or Hashimoto's encephalopathy). Intern Emerg Med. 2006, 1 (1): 15-23.View ArticlePubMedGoogle Scholar
  3. Galluzzi S, Geroldi C, Zanetti O, Frisoni GB: Hashimoto's encephalopathy in the elderly: relationship to cognitive impairment. J Geriatr Psychiatry Neurol. 2002, 15 (3): 175-9.View ArticlePubMedGoogle Scholar
  4. Kothbauer-Margreiter I, Sturzenegger M, Komor J, Baumgartner R, Hess CW: Encephalopathy associated with Hashimoto thyroiditis: diagnosis and treatment. J Neurol. 1996, 243 (8): 585-93. 10.1007/BF00900946.View ArticlePubMedGoogle Scholar

Copyright

© Spyridi et al.; licensee BioMed Central Ltd. 2008

This article is published under license to BioMed Central Ltd.

Advertisement