Hashimoto's encephalopathy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]

Synonyms and keywords: steroid-responsive encephalopathy associated with autoimmune thyroiditis, SREAT

Overview

Hashimoto's Encephalopathy is a very rare condition associated with Hashimoto's thyroiditis. Hashimoto's Encephalopathy is a neuroendocrine disorder. Much like the antibodies in Hashimoto's thyroiditis attack the thyroid, in Hashimoto's encephalopathy, antibodies attack neurons of the brain.

Differentiating Hashimoto's encephalopathy from other disease

Pathophysiology

A few theories are proposed for Hashimoto encephalopathy.

  • Neuronal injury due to antibody mediated destruction.

Diagnosis

Symptoms

  • Concentration and memory problems

Physical examination

  • Jerks in the muscles
  • Lack of coordination
  • Speech problems

Laboratory Findings

Blood and Biomarker Studies

  • Anti thyroid peroxidase levels
  • CSF analysis - increased protein concentration, lymphocytic pleocytosis

Electroencephalogram

  • Generalized slowing of activity

CT and MRI

  • Non specific and show normal results
  • In few patients atrophy may be seen

Treatment

Steroids or immunosuppressant treatment, this condition is now also referred to as "steroid-responsive" encephalopathy.

References


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