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Clinical and diagnostic aspects of encephalopathy associated with autoimmune thyroid disease (or Hashimoto’s encephalopathy)

  • Internal Medicine
  • Review Article Neurology
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Abstract

Encephalopathy associated with autoimmune thyroid disease, currently known as Hashimoto’s encephalopathy, but also defined as corticosteroid-responsive encephalopathy associated with autoimmune thyroiditis, is a relatively rare condition observed in a small percentage of patients presenting with autoimmune thyroid disease. It consists of a subacute, relapsing-remitting, steroid-responsive encephalopathy characterised by protean neurologic and neuropsychiatric symptoms, diffuse electroencephalographic abnormalities and increased titres of antithyroid antibodies in serum and/or in cerebrospinal fluid. Most of the cases presenting this neurologic complication are affected by Hashimoto’s thyroiditis or, less frequently, by other autoimmune thyroid diseases, chiefly Graves’ disease.

The pathogenesis of this encephalopathy is still unknown and largely debated, because of extremely varied clinical presentation, possibly referable to different aetiologic and pathophysiologic mechanisms, as confirmed by the two clinical cases we report in this paper. Autoimmune aetiology is, however, very likely in view of the well established favourable response to corticosteroid administration. Both vasculitis and autoimmunity directed against common brainthyroid antigens represent the most probable aetiologic pathways.

Clinical manifestations include consciousness changes, neurologic diffuse or focal signs, headache, and altered cognitive function. Although unspecific, cerebral oedema has also been described. Cerebrospinal fluid examination often discloses an inflammatory process, with a mild increase in protein content and occasionally in lymphocyte count. In this review, clinical criteria for the diagnosis of defined, probable, or possible encephalopathy associated with autoimmune thyroid disease are suggested. Corticosteroid therapy currently allows us to obtain rapid remission of disease symptoms, but adverse outcomes as well as spontaneous remissions have also been reported.

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References

  1. Brain L, Jellinek EH, Ball K. Hashimoto’s disease and encephalopathy.Lancet 1966; 2: 512–4.

    Article  PubMed  CAS  Google Scholar 

  2. Shaw PJ, Walls TJ, Newman PK, Cleland PG, Cartlidge NE. Hashimoto’s encephalopathy: a steroid-responsive disorder associated with high anti-thyroid antibody titers—report of five cases.Neurology 1991; 41: 228–33.

    PubMed  CAS  Google Scholar 

  3. Canton A, de Fabregas O, Tintore M, Mesa J, Codina A, Simo R. Encephalopathy associated to autoimmune thyroid disease: a more appropriate term for an underestimated condition?J Neurol Sci 2000; 176: 65–9.

    Article  PubMed  CAS  Google Scholar 

  4. Sawka AM, Fatourechi V, Boeve BF, Mokri B. Rarity of encephalopathy associated with autoimmune thyroiditis: a case series from Mayo Clinic from 1950 to 1996.Thyroid 2002; 12: 393–8.

    Article  PubMed  Google Scholar 

  5. Bertoni M, Falcini M, Sestini S, Nicoli L, Nannini C, Cantini F. Encephalopathy associated with Hashimoto’s thyroiditis: an additional case.Eur J Intern Med 2003; 14: 434–7.

    Article  PubMed  Google Scholar 

  6. Sommerfield AJ, Stimson R, Campbell IW. Hashimoto’s encephalopathy presenting as an acute medical emergency.Scott Med J 2004; 49: 155–6.

    PubMed  CAS  Google Scholar 

  7. Fatourechi V. Hashimoto’s encephalopathy: myth or reality? An endocrinologist’s perspective.Best Pract Res Clin Endocrinol Metab 2005; 19: 53–66.

    Article  PubMed  CAS  Google Scholar 

  8. Vasconcellos E, Pina-Garza JE, Fakhoury T, Fenichel GM. Pediatric manifestations of Hashimoto’s encephalopathy.Pediatr Neurol 1999; 20: 394–8.

    Article  PubMed  CAS  Google Scholar 

  9. Sybesma CA, van Pinxteren-Nagler E, Sinnige LG, van Oostrom JC, de Vries TW. Hashimoto encephalopathy in a 12-year-old girl.Eur J Pediatr 1999; 158: 867–8.

    Article  PubMed  CAS  Google Scholar 

  10. Watemberg N, Willis D, Pellock JM. Encephalopathy as the presenting symptom of Hashimoto’s thyroiditis.J Child Neurol 2000; 15: 66–9.

    Article  PubMed  CAS  Google Scholar 

  11. von Maydell B, Kopp M, Komorowski G, Joe A, Juengling FD, Korinthenberg R. Hashimoto encephalopathy—is it underdiagnosed in pediatric patients?.Neuropediatrics 2002; 33: 86–9.

    Article  Google Scholar 

  12. Janes SE, Santosh B, Thomas D, Vyas H. Hashimoto’s encephalopathy: an unusual cause of seizures in the intensive care unit.Pediatr Crit Care Med 2004; 5: 578–81.

    Article  PubMed  Google Scholar 

  13. Mancardi MM, Fazzini F, Rossi A, Gaggero R. Hashimoto’s encephalopathy with selective involvement of the nucleus accumbens: a case report.Neuropediatrics 2005; 36: 218–20.

    Article  PubMed  CAS  Google Scholar 

  14. Gayatri NA, Whitehouse WP. Pilot survey of Hashimoto’s encephalopathy in children.Dev Med Child Neurol 2005; 47: 556–8.

    Article  PubMed  Google Scholar 

  15. Saito H, Fujita N, Miyakoshi M, Arai A, Nagai H. A case of Hashimoto’s encephalopathy associated with Graves’ disease.Rinsho Shinkeigaku 2002; 42: 619–22.

    PubMed  Google Scholar 

  16. Seo SW, Lee BI, Lee JD et al. Thyrotoxic autoimmune encephalopathy: a repeat positron emission tomography study.J Neurol Neurosurg Psychiatry 2003; 74: 504–6.

    Article  PubMed  CAS  Google Scholar 

  17. Utku U, Asil T, Celik Y, Tucer D. Reversible MR angiographic findings in a patient with autoimmune Graves disease.Am J Neuroradiol 2004; 25: 1541–3.

    PubMed  Google Scholar 

  18. Mahad DJ, Staugaitis S, Ruggieri P, et al. Steroid-responsive encephalopathy associated with autoimmune thyroiditis and primary CNS demyelination.J Neurol Sci 2005; 228: 3–5.

    Article  PubMed  Google Scholar 

  19. Passarella B, NegroC, Nozzoli C, De Marco V, Rini A. Cerebellar subacute syndrome due to corticosteroid-responsive encephalopathy associated with autoimmune thyroiditis (also called “Hashimoto’s encephalopathy”).Clin Ter 2005; 156: 13–7.

    PubMed  CAS  Google Scholar 

  20. Ghawche F, Bordet R, Destee A. Hashimoto’s encephalopathy: toxic or autoimmune mechanism?Rev Neurol (Paris) 1992; 148: 371–3.

    CAS  Google Scholar 

  21. Forchetti CM, Katsamakis G, Garron DC. Autoimmune thyroiditis and a rapidly progressive dementia: global hypoperfusion on SPECT scanning suggests a possible mechanism.Neurology 1997; 49: 623–6.

    PubMed  CAS  Google Scholar 

  22. Nolte KW, Unbehaun A, Sieker H, Kloss TM, Paulus W. Hashimoto encephalopathy: a brainstem vasculitis?Neurology 2000; 54: 769–70.

    PubMed  CAS  Google Scholar 

  23. Archambeaud F, Galinat S, Regouby Y, et al. Hashimoto encephalopathy. Analysis of four case reports.Rev Med Interne 2001; 22; 653–9.

    PubMed  CAS  Google Scholar 

  24. Zettinig G, Asenbaum S, Fueger BJ, et al. Increased prevalence of subclinical brain perfusion abnormalities in patients with autoimmune thyroiditis: evidence of Hashimoto’s encephalitis?.Clin Endocrinol (Oxf) 2003; 59: 637–43.

    Article  Google Scholar 

  25. Ferracci F, Moretto G, Candeago RM, et al. Antithyroid antibodies in the CSF: their role in the pathogenesis of Hashimoto’s encephalopathy.Neurology 2003; 60: 712–4.

    PubMed  CAS  Google Scholar 

  26. Ferraci F, Bertiato G, Moretto G. Hashimoto’s encephalopathy: epidemiologic data and pathogenetic considerations.J Neurol Sci 2004; 217: 165–8.

    Article  Google Scholar 

  27. Byrne OC, Zuberi SM, Madigan CA, King MD. Hashimoto’s thyroiditis—a rare but treatable cause of encephalopathy in children.Eur J Pediatr Neurol 2000; 4: 279–82.

    Article  CAS  Google Scholar 

  28. Sellal F, Berton C, Andriantseheno M, Clerc C. Hashimoto’s encephalopathy: exacerbations associated with menstrual cycle.Neurology 2002; 59: 1633–5.

    Article  PubMed  CAS  Google Scholar 

  29. Ishii K, Hayashi A, Tamaoka A, Mizusawa H, Shoji S. A case of Hashimoto’s encephalopathy with a relapsing course related to menstrual cycle.Rinsho Shinkeigaku 1993; 33: 995–7.

    PubMed  CAS  Google Scholar 

  30. Querol Pascual MR, Aguirre Sanchez JJ, Velicia Mata MR, Gahete Jimenez C, Duran Herrera MC, Gonzalez Dorrego F. Hashimoto’s encephalitis: a new case with spontaneous remission.Neurologia 2000; 15: 313–6.

    PubMed  CAS  Google Scholar 

  31. Jacob S, Rajabally YA. Hashimoto’s encephalopathy: steroid resistance and response to intravenous immunoglobulins [letter].J Neurol Neurosurg Psychiatry 2005; 76: 455–6.

    Article  PubMed  CAS  Google Scholar 

  32. Latinville D, Bernardi O, Cougoule JP, et al. Hashimoto’s thyroiditis and myoclonic encephalopathy. Pathogenic hypothesis.Rev Neurol (Paris) 1985; 141: 55–8.

    CAS  Google Scholar 

  33. Shein M, Apter A, Dickerman Z, Tyano S, Gadoth N. Encephalopathy in compensated Hashimoto thyroiditis: a clinical expression of autoimmune cerebral vasculitis.Brain Dev 1986; 8: 60–4.

    PubMed  CAS  Google Scholar 

  34. Shibata N, Yamamoto Y, Sunami N, Suga M, Yamashita Y. Isolated angiitis of the CNS associated with Hashimoto’s disease.Rinsho Shinkeigaku 1992; 32: 191–8.

    PubMed  CAS  Google Scholar 

  35. Takahashi S, MitamuraR, Itoh Y, Suzuki N, Okuno A. Hashimoto encephalopathy: etiologic considerations.Pediatr Neurol 1994; 11:328–31.

    Article  PubMed  CAS  Google Scholar 

  36. Doherty CP, Schlossmacher M, Torres N, Bromfield E, Samuels MA, Folkerth R. Hashimoto’s encephalopathy mimicking Creutzfeldt-Jakob disease: brain biopsy findings.J Neurol Neurosurg Psychiatry 2002; 73: 601–2.

    Article  PubMed  CAS  Google Scholar 

  37. Perrot X, Giraud P, Biacabe AG, et al. Hashimoto’s encephalopathy: an anatomicoclinical observation.Rev Neurol (Paris) 2002; 158: 461–6.

    CAS  Google Scholar 

  38. Ochi H, Ochi H, Horiuchi I, et al. Proteomic analysis of human brain identifies alpha-enolase as a novel autoantigen in Hashimoto’s encephalopathy.FEBS Lett 2002; 528: 197–202.

    Article  PubMed  CAS  Google Scholar 

  39. Oide T, Tokuda T, Yazaki M, et al. Anti-neuronal autoantibody in Hashimoto’s encephalopathy: neuropathological, immunohistochemical, and biochemical analysis of two patients.J Neurol Sci 2004; 217: 7–12.

    Article  PubMed  CAS  Google Scholar 

  40. Fujii A, Yoneda M, Ito T, et al. Autoantibodies against the amino terminal of alpha-enolase are a useful diagnostic marker of Hashimoto’s encephalopathy.J Neuroimmunol 2005; 162: 130–6.

    Article  PubMed  CAS  Google Scholar 

  41. Ishii K, Hayashi A, Tamaoka A, Usuki S, Mizusawa H, Shoji S. Case report: thyrotropin-releasing hormone-induced myoclonus and tremor in a patient with Hashimoto’s encephalopathy.Am J Med Sci 1995; 310: 202–5.

    Article  PubMed  CAS  Google Scholar 

  42. Chaudhuri A, Behan PO. Hashimoto’s encephalopathy: a relapsing form of acute disseminated encephalomyelitis [letter].J Neurol Sci 2005; 235:75–6.

    Article  PubMed  Google Scholar 

  43. Kothbauer-Margreiter I, Sturzenegger M, Komor J, Baumgartner R, Hess CW. Encephalopathy associated with Hashimoto thyroiditis: diagnosis and treatment.J Neurol 1996; 243: 585–93.

    Article  PubMed  CAS  Google Scholar 

  44. Becker H, Hofmann M, von Einsiedel H, Conrad B, Sander D. Circumscribed vasculitis with posterior infarct in Hashimoto encephalopathy.Nervenarzt 2002; 73: 376–9.

    Article  PubMed  CAS  Google Scholar 

  45. Chong JY, Rowland LP, Utiger RD. Hashimoto encephalopathy. Syndrome or myth?.Arch Neurol 2003; 60: 164–71.

    Article  PubMed  Google Scholar 

  46. Cao NJ, Tselis AC, Li J, Gorman M. A case of Hashimoto’s encephalopathy: association with sensory ganglionopathy.J Neurol Sci 2005; 238: 105–7.

    Article  PubMed  Google Scholar 

  47. Josephs KA, Rubino FA, Dickson DW. Nonvasculitic autoimmune inflammatory meningoencephalitis.Neuropathology 2004; 24: 149–52.

    Article  PubMed  Google Scholar 

  48. Castillo PR, Mignot E, Woodruff BK, Boeve BF. Undetectable CSF hypocretin-1 in “Hashimoto’s encephalopathy” associated with coma [letter].Neurology 2004; 62: 1909.

    PubMed  Google Scholar 

  49. Mignot E, Taheri S, Nishino S. Sleeping with the hypothalamus: emerging therapeutic targets for sleep disorders.Nat Neurosci 2002; 5 (Suppl): 1071–5.

    Article  PubMed  CAS  Google Scholar 

  50. Manto M, Goldman S, Bodur H. Cerebellar syndrome associated with Hashimoto’s encephalopathy.Rev Neurol (Paris) 1996; 152: 202–4.

    CAS  Google Scholar 

  51. Ghika-Schmid F, Ghika J, Regli F, et al. Hashimoto’s myoclonic encephalopathy: an underdiagnosed treatable conditions?.Mov Disord 1996; 11: 555–62.

    Article  PubMed  CAS  Google Scholar 

  52. Bostantjopoulou S, Zafiriou D, Katsarou Z, Kazis A. Hashimoto’s encephalopathy: clinical and laboratory findings.Funct Neurol 1996; 11: 247–51.

    PubMed  CAS  Google Scholar 

  53. van Oostrom JC, Schaafsma A, Haaxma R. Variable manifestations of Hashimoto’s encephalopathy.Ned Tijdschr Geneeskd 1999; 143: 1319–22.

    PubMed  Google Scholar 

  54. Peschen-Rosin R, Schabet M, Dichgans J. Manifestation of Hashimoto’s encephalopathy years before onset of thyroid disease.Eur Neurol 1999; 41: 79–84.

    Article  PubMed  CAS  Google Scholar 

  55. Chen HC, Marsharani U. Hashimoto’s encephalopathy.South Med J 2000; 93: 504–6.

    PubMed  CAS  Google Scholar 

  56. Garrard P, Hodges JR, De Vries PJ, et al. Hashimoto’s encephalopathy presenting as “myxoedematous madness”.J Neurol Neurosurg Psychiatry 2000; 68: 102–3.

    Article  PubMed  CAS  Google Scholar 

  57. Gucuyener K, Serdaroglu A, Bideci A, Yazman Y, Soysal AS, Cinaz P. Tremor and myoclonus heralding Hashimoto’s encephalopathy.J Pediatr Endocrinol Metab 2000; 13: 1137–41.

    PubMed  CAS  Google Scholar 

  58. McCabe DJ, Burke T, Connolly S, Hutchinson M. Amnesic syndrome with bilateral mesial temporal lobe involvement in Hashimoto’s encephalopathy.Neurology 2000; 54: 737–9.

    PubMed  CAS  Google Scholar 

  59. McGinley J, McCabe DJ, Fraser A, Casey E, Ryan T, Murphy R. Hashimoto’s encephalopathy; an unusual cause of status epilepticus [letter].Ir Med J 2000; 93: 118.

    PubMed  CAS  Google Scholar 

  60. Papathanasopoulos P, Mallioris K, Karanasios P, Dimopoulos D, Papapetropoulos T. Febrile Hashimoto’s encephalopathy [letter].J Neurol Neurosurg Psychiatry 2000; 68: 795.

    Article  PubMed  CAS  Google Scholar 

  61. Arain A, Abou-Khalil B, Moses H. Hashimoto’s encephalopathy: documentation of mesial temporal seizure origin by ictal EEG.Seizure 2001; 10: 438–41.

    PubMed  CAS  Google Scholar 

  62. Calvet D, Touze E, Delegue P, Bertherat J, Zuber M. Stiff limb syndrome associated with Hashimoto’s encephalopathy: improvement after corticotherapy.Rev Neurol (Paris) 2002; 158: 602–4.

    CAS  Google Scholar 

  63. Taurin G, Golfier V, Pinel JF, et al. Choreic syndrome due to Hashimoto’s encephalopathy.Mov Disord 2002; 17: 1091–2.

    Article  PubMed  Google Scholar 

  64. Chaudhuri A, Behan PO. The clinical spectrum, diagnosis, pathogenesis and treatment of Hashimoto’s encephalopathy (recurrent acute disseminated encephalomyelitis).Curr Med Chem 2003; 10: 1945–3.

    Article  PubMed  CAS  Google Scholar 

  65. Avila A, Serrado A, Reig L, Famades A, Maho P. Early presentation of gait disturbance in a steroid-responsive encephalopathy associated with autoimmune thyroiditis [letter].Eur J Neurol 2003; 10: 601.

    Article  PubMed  CAS  Google Scholar 

  66. Duffey P, Yee S, Reid IN, Bridges LR. Hashimoto’s encephalopathy: postmortem findings after fatal status epilepticus.Neurology 2003; 61: 1124–6.

    PubMed  Google Scholar 

  67. Kalita J, Misra UK, Rathore C, Pradhan PK, Das BK. Hashimoto’s encephalopathy: clinical, SPECT and neurophysiological data.QJM 2003; 96: 455–7.

    Article  PubMed  CAS  Google Scholar 

  68. Mahmud FH, Lteif AN, Renaud DL, Reed AM, Brands CK. Steroid-responsive encephalopathy associated with Hashimoto’s thyroiditis in an adolescent with chronic hallucinations and depression: case report and review.Pediatrics 2003; 112: 686–90.

    Article  PubMed  Google Scholar 

  69. Rekand T, Vedeler C, Gramstad A, Bindoff L. Hashimoto’s encephalopathy: a treatable cause of mental impairment, stroke and seizures.Eur J Neurol 2003; 10: 746–7.

    Article  PubMed  CAS  Google Scholar 

  70. Taylor SE, Garalda ME, Tudor-Williams G, Martinez-Alier N. An organic cause of neuropsychiatric illness in adolescence [letter].Lancet 2003; 361: 572.

    Article  PubMed  CAS  Google Scholar 

  71. Sheng B, Lau KK, Li HL, Cheng LF. A case of Hashimoto’s encephalopathy with demyelinating peripheral neuropathy.Eur Neurol 2005; 53: 84–5.

    Article  PubMed  Google Scholar 

  72. Kastrup O, Maschke M, Schlamann K, Diener HC. Hashimoto encephalopathy and neuralgic amyotrophy—causal link or chance association?Eur Neurol 2005; 53: 98–9.

    Article  PubMed  CAS  Google Scholar 

  73. McKeon A, McNamara B, Sweeney B. Hashimoto’s encephalopathy presenting with psychosis and generalized absence status.J Neurol 2004; 25: 1025–7.

    Google Scholar 

  74. Mussig K, Bartels M, Gallwitz B, Leube D, Haring HU, Kircher T. Hashimoto’s encephalopathy presenting with bipolar affective disorder.Bipolar Disord 2005; 7: 292–7.

    Article  PubMed  Google Scholar 

  75. Ferlazzo E, Raffaele M, MazzuI, Pisani F. Recurrent status epilepticus as the main feature of Hashimoto’s encephalopathy.Epilepsy Behav 2006; 8: 328–30.

    Article  PubMed  Google Scholar 

  76. Gawron W, Pospiech L, Noczynska A, Orendorz-Fraczkowska K. Electrophysiological tests of the hearing organ in Hashimoto’s disease.J Pediatr Endocrinol Metab 2004; 17: 27–32.

    PubMed  Google Scholar 

  77. Galluzzi S, Geroldi C, Zanetti O, Frisoni GB. Hashimoto’s encephalopathy in the elderly: relationship to cognitive impairment.J Geriatr Psychiatry Neurol 2002; 15: 175–9.

    PubMed  Google Scholar 

  78. Caicoya AG, Barco-Nebreda L, Gonzalez-Gutierrez JL, Egido-Herrero JA. Hashimoto’s encephalopathy associated with scleromyxedema: coincidental or the overlapping of two syndromes with a possible autoimmune origin?Rev Neurol 2004; 39: 723–6.

    PubMed  CAS  Google Scholar 

  79. Betterle C, Dal Pra C, Mantero F, Zanchetta R. Autoimmune adrenal insufficiency and autoimmune polyendocrine syndromes: autoantibodies, autoantigens, and their applicability in diagnosis and disease prediction.Endocr Rev 2002; 23: 327–64.

    Article  PubMed  CAS  Google Scholar 

  80. Pozo-Rosich P, Villoslada P, Canton A, Simo R, Rovira A, Montalban X. Reversible white matter alterations in encephalopathy associated with autoimmune thyroid disease.J Neurol 2002; 249: 1063–5.

    Article  PubMed  Google Scholar 

  81. Schauble B, Castillo PR, Boeve BF, Westmoreland BF. EEG findings in steroid-responsive encephalopathy associated with autoimmune thyroiditis.Clin Neurophysiol 2003; 114: 32–7.

    Article  PubMed  Google Scholar 

  82. Henchey R, Cibula J, Helveston W, Malone J, Gilmore RL. Electroencephalographic findings in Hashimoto’s encephalopathy.Neurology 1995; 45: 977–81.

    PubMed  CAS  Google Scholar 

  83. Spiegel J, Hellwig D, Becker G, Muller M. Progressive dementia caused by Hashimoto’s encephalopathy—report of two cases.Eur J Neurol 2004; 11: 711–3.

    Article  PubMed  CAS  Google Scholar 

  84. Vander T, Hallevy C, Alsaed I, Valdman S, Ifergane G, Wirguin I. 14-3-3 protein in the CSF of a patient with Hashimoto’s encephalopathy.J Neurol 2004; 251: 1273–4.

    Article  PubMed  CAS  Google Scholar 

  85. Bohnen NI, Parnell KJ, Harper CM. Reversible MRI findings in a patient with Hashimoto’s encephalopathy.Neurology 1997; 49: 246–7.

    PubMed  CAS  Google Scholar 

  86. Song YM, Seo DW, Chang GY. MR findings in Hashimoto encephalopathy.AJNR Am J Neuroradiol 2004; 25: 807–8.

    PubMed  Google Scholar 

  87. Piga M, Serra A, Deiana L, et al. Brain perfusion abnormalities in patients with euthyroid autoimmune thyroiditis.Eur J Nucl Med Mol Imaging 2004; 31: 1639–44.

    Article  PubMed  CAS  Google Scholar 

  88. Chen PL, Wang PY, Hsu HY. Reversible electroencephalographic and single photon emission computed tomography abnormalities in Hashimoto’s encephalopathy.J Chin Med Assoc 2005; 68: 77–81.

    Article  PubMed  Google Scholar 

  89. Doherty CP. Possibly, probably definitely, Hashimoto encephalopathy.J Neurol Sci 2005; 228: 1–2.

    Article  PubMed  Google Scholar 

  90. Wilhelm-Gossling C, Weckbecker K, Brabant EG, Dengler R. Autoimmune encephalopathy in Hashimoto’s thyroiditis. A differential diagnosis in progressive dementia syndrome.Dtsch Med Wochenschr 1998; 123: 279–84.

    PubMed  CAS  Google Scholar 

  91. Cossu G, Melis M, Molari A, et al. Creutzfeld-Jakob disease associated with high titer of antithyroid autoantibodies: case report and literature review.Neurol sci 2003; 24: 138–40.

    Article  PubMed  CAS  Google Scholar 

  92. Feldt-Rasmussen U, Bech K, Date J, Petersen PH, Johansen K. A prospective study of the differential changes in serum thyroglobulin and its autoantibodies during propylthiouracil or radioiodine therapy of patients with Graves’ disease.Acta Endocrinol (Covenh) 1982; 99: 379–85.

    CAS  Google Scholar 

  93. Barker R, Zajicek J, Wilkinson I. Thyrotoxic Hashimoto’s encephalopathy [letter].J Neurol Neurosurg Psychiatry 1996; 60: 234.

    PubMed  CAS  Google Scholar 

  94. Ohmori N, Tushima T, Sekine Y, et al. Gestational thyrotoxicosis with acute Wernicke encephalopathy: a case report.Endocr J 1999;46: 787–93.

    Article  PubMed  CAS  Google Scholar 

  95. Hernandez Echebarria LE, Saiz A, Graus F, et al. Detection of 14-3-3 protein in the CSF of a patient with Hashimoto’s encephalopathy.Neurology 2000; 54: 1539–40.

    PubMed  CAS  Google Scholar 

  96. Erickson JC, Carrasco H, Grimes JB, Jabbari B, Cannard KR. Palatal tremor and myorhythmia in Hashimoto’s encephalopathy.Neurology 2002; 58: 504–5.

    PubMed  CAS  Google Scholar 

  97. Magy L, Vallat JM. Hashimoto’s encephalitis.Rev Neurol (Paris) 2002; 158: 966–70.

    CAS  Google Scholar 

  98. Desai J, Wadia N. Hashimoto’s encephalopathy.J Neurol Sci 1999; 163: 202–4.

    Article  PubMed  CAS  Google Scholar 

  99. Hartmann M, Schaner B, Scheglmann K, Bucking A, Pfister R. Hashimoto encephalopathy: steroid-sensitive encephalopathy in Hashimoto thyroiditis.Nervenarzt 2000; 71: 489–94.

    Article  PubMed  CAS  Google Scholar 

  100. Hussain NS, Rumbaugh J, Kerr D, Nath A, Hillis AE. Effects of prednisone and plasma exchange on cognitive impairment in Hashimoto encephalopathy.Neurology 2005; 64: 165–6.

    Article  PubMed  CAS  Google Scholar 

  101. Castillo PR, Boeve BF, Caselli RJ. Steroid responsive encephalopathy associated with thyroid autoimmunity: clinical and laboratory findings [abstract].Neurology 2002; 58 (Suppl 3): A248.

    Google Scholar 

  102. Boers PM, Colebatch JG. Hashimoto’s encephalopathy responding to plasmapheresis [letter].J Neurol Neurosurg Psychiatry 2001; 70: 132.

    Article  PubMed  CAS  Google Scholar 

  103. Nagpal T, Pande S. Hashimoto’s encephalopathy: response to plasma exchange.Neurol India 2004; 52: 245–7.

    PubMed  Google Scholar 

  104. Nieuwenhuis L, Santens P, Vanwalleghem P, Boon P. Subacute Hashimoto’s encephalopathy, treated with plasmapheresis.Acta Neurol Belg 2004; 104: 80–3.

    PubMed  CAS  Google Scholar 

  105. Ares Luque A, Ballesteros Pomar MD, Hernandez Echebarria L. Hashimoto’s encephalopathy.Neurologia 2002; 17: 628–32.

    PubMed  CAS  Google Scholar 

  106. Gunther P, Kopf A. Hashimoto encephalopathy.Psychiatr Prax 2004; 31: 310–2.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Medical Clinic 3, Department of Medical and Surgical Sciences, University of Padua, Padua

    Gianluca Tamagno & Giovanni Federspil

  2. Clinica di Medicina Interna 2, Dipartimento di Scienze Endocrinologiche e Metaboliche, Università degli Studi, Viale Benedetto XV 6, 16132, Genova, Italy

    Giovanni Murialdo

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  1. Gianluca Tamagno
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Tamagno, G., Federspil, G. & Murialdo, G. Clinical and diagnostic aspects of encephalopathy associated with autoimmune thyroid disease (or Hashimoto’s encephalopathy). Int Emergency Med 1, 15–23 (2006). https://doi.org/10.1007/BF02934715

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