Hashimoto's encephalopathy: Difference between revisions
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{{SI}} | {{SI}} | ||
{{CMG}} | {{CMG}}; {{AE}} {{ADI}} | ||
{{SK}} steroid-responsive encephalopathy associated with autoimmune thyroiditis, SREAT | |||
==Overview== | ==Overview== | ||
'''Hashimoto's Encephalopathy''' is a very rare condition associated with [[Hashimoto's | '''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== | |||
* [[Stroke]] - associated symptoms of [[paresis ]] | |||
* [[Alzheimer's disease]]- seen in old age and [[dementia]] is the most prominent symptom | |||
==Pathophysiology== | ==Pathophysiology== | ||
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]]. | |||
==Diagnosis== | ==Diagnosis== | ||
===Symptoms=== | ===Symptoms=== | ||
* Headache | * [[Headache]] | ||
* Disorientation | * [[Disorientation]] | ||
* Psychosis | * [[Psychosis]] | ||
* Tremors | * [[Tremors]] | ||
* Concentration and memory problems | * Concentration and memory problems | ||
| Line 32: | Line 47: | ||
* Speech problems | * Speech problems | ||
== | ===Laboratory Findings=== | ||
====Blood and Biomarker Studies==== | |||
* Blood [[TSH]], [[T3]], [[T4]] levels | |||
* | * 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== | ==Treatment== | ||
[[Steroids]] or [[immunosuppressant]] treatment, this condition is now also referred to as "[[steroid]]-responsive" encephalopathy. | [[Steroids]] or [[immunosuppressant]] treatment, this condition is now also referred to as "[[steroid]]-responsive" encephalopathy. | ||
==References== | ==References== | ||
Latest revision as of 01:46, 6 August 2012
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
- Alzheimer's disease- seen in old age and dementia is the most prominent symptom
Pathophysiology
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.
Diagnosis
Symptoms
- Concentration and memory problems
Physical examination
- Jerks in the muscles
- Lack of coordination
- Partial paralysis
- 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.