Hashimoto's encephalopathy

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.

• Stroke – associated symptoms of paresis

• Alzheimer’s disease– seen in old age and dementia is the most prominent symptom

A few theories are proposed for Hashimoto encephalopathy.

• Neuronal injury due to antibody mediated destruction.

• Immmune complex mediated vasculitis
• Toxic effect of increased thyroid stimulating hormone.

• Headache

• Disorientation

• Psychosis

• Tremors

• Concentration and memory problems

• Jerks in the muscles

• Lack of coordination

• Partial paralysis

• Speech problems

• Blood TSH, T3, T4 levels

• Anti thyroid peroxidase levels

• CSF analysis – increased protein concentration, lymphocytic pleocytosis

• Generalized slowing of activity

• Non specific and show normal results

• In few patients atrophy may be seen

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

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