A case of steroid-resistance Hashimoto's encephalopathy presenting with sensorimotor polyneuropathy

Abstract

Hashimoto's encephalopathy (HE) is a rare, auto-immune disease characterized by symptoms of acute or subacute encephalopathy associated with increased anti-thyroid antibody levels. The course of most HE cases is relapsing and remitting, which is similar to that of vasculitis and stroke. Steroids are the first line treatment in HE. In steroid non-responders other immunomodulatory therapies or plasmapheresis could be applied. We report a case of steroidresistance HE with sensorimotor polyneuropathy, as a rare presentation of this disorder. Our case showed that HE may present with sensorimotor polyneuropathy; therefore HE should be considered in the differential diagnoses of polyneuropathy.

Hashimoto’s Encephalopathy Mimicking Viral Encephalitis: A Case Report

“…After biopsy, it was found that the lesion was not a tumor, and HE was finally confirmed (Uwatoko et al, 2018). Patients with HE can also present with unusual symptoms such as pseudobulbar palsy, sensorimotor polyneuropathy, catatonic symptoms, vertigo, muscle weakness, chorea, opsoclonus, and a trigeminal neuralgia type headache, among others (Beckmann et al, 2011;Salazar et al, 2012;Sharan et al, 2015;Ueno et al, 2016;Karthik et al, 2017;Emeksiz et al, 2018;Oz Tuncer et al, 2018). Rapidly progressive dementia, as a common manifestation of HE, makes it necessary to distinguish HE from other diseases caused by vascular, infectious, toxic-metabolic, and autoimmune factors, metastasis/neoplasia, iatrogenic/inborn errors of metabolism, neurodegenerative diseases, and systemic diseases/seizures (Paterson et al, 2012).…”