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We describe 5 patients with a relapsing encephalopathy in association with Hashimoto's disease and high titers of anti-thyroid antibodies.The presentation is usually with a subacute onset of confusion,alteration in conscious level,and focal or generalized seizures.The relapsing course, association with myoclonus or tremulousness,and episodes of stroke-like deterioration are characteristic features.The long-term prognosis is favorable with steroid therapy,though additional immunosuppressive therapy may be required.Neurologic investigation typically shows a diffusely abnormal EEG,high CSF protein level without pleocytosis,and normal brain CT and cerebral angiogram.Isotope brain scan may show patchy abnormal uptake.Hashimoto's encephalopathy should be recognized as a definite neurologic entity and added to the list of CNS complications of thyroid disease. |
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altered states of consciousness
cerebrospinal fluid,elevated protein of
coma
confusion
electroencephalogram,abnormalities of
encephalopathy
encephalopathy,Hashimoto's
mental status,abnormal
myoclonus
neurologic complications of,systemic disease
prognosis
seizure
steroid therapy,CNS treatment and complications with
thyroid stimulating immunoglobulins
thyroiditis
treatment of neurologic disorder
tremor
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