Opsoclonus as a manifestation of Hashimoto’s encephalopathy

Salazar, Richard; Mehta, Chandan; Zaher, Naoir; Miller, Daniel J.

doi:10.1016/j.jocn.2012.02.012

Cited by 13 publications

(6 citation statements)

References 12 publications

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“…Opsoclonus (i.e., chaotic saccadic eye movements) may also present as an early manifestation of HE 33,34 and is associated with ataxia prior to the development of encephalopathy. 34 Two clinical subtypes of HE have been suggested.…”

Section: Clinical Presentationsmentioning

confidence: 99%

“…31 The development of psychosis has also been described during the course of corticosteroid therapy in some HE patients. 32 Opsoclonus (i.e., chaotic saccadic eye movements) may also present as an early manifestation of HE 33,34 and is associated with ataxia prior to the development of encephalopathy. 34 Two clinical subtypes of HE have been suggested.…”

Section: Clinical Presentationsmentioning

confidence: 99%

“…32 Opsoclonus (i.e., chaotic saccadic eye movements) may also present as an early manifestation of HE 33,34 and is associated with ataxia prior to the development of encephalopathy. 34 Two clinical subtypes of HE have been suggested. The first subtype is episodic and manifests as stroke-like symptoms described to be of the vasculitis type and with a relapsing-remitting course.…”

Section: Clinical Presentationsmentioning

confidence: 99%

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Hashimoto encephalopathy: literature review

et al. 2016

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Hashimoto encephalopathy (HE) presents as an encephalopathy without central nervous system infection or tumor. HE is associated with autoimmune thyroiditis and is thus considered to be an autoimmune disorder. The prevalence of HE is low, but death and status epilepticus have been reported. HE manifests with a wide range of symptoms that include behavioral changes and confusion. Elevated thyroid antibodies are present in the majority of cases and are required for the diagnosis of HE. Normal brain MRI findings are found in the majority of patients diagnosed with HE. The most consistent CSF abnormality noted in HE patients is the presence of elevated protein. Most HE patients respond well to steroid therapy. Clinical improvements are also observed with IV immunoglobulin and plasmapheresis. In conclusion, it is now generally accepted that the diagnosis of HE must include encephalopathy characterized by cognitive impairment associated with psychiatric features, such as hallucinations, delusions, and paranoia. Autoimmune encephalitis and prion disease should be considered in the differential diagnosis due to the similarity of the clinical features of these conditions to those of HE.

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Section: Clinical Presentationsmentioning

confidence: 99%

Section: Clinical Presentationsmentioning

confidence: 99%

Section: Clinical Presentationsmentioning

confidence: 99%

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Hashimoto encephalopathy: literature review

et al. 2016

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“…ATANDS with associated movement disorders have been described previously (Table 1 ) [ 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 ]. We have reported a 16-year-old female with ATANDS who presented with acute pure chorea without encephalopathy.…”

Section: Discussionmentioning

confidence: 99%

Anti-Thyroid Peroxidase/Anti-Thyroglobulin Antibody-Related Neurologic Disorder Responsive to Steroids Presenting with Pure Acute Onset Chorea

Ghosh¹,

Chatterjee²,

Dubey³

et al. 2020

Tremor and Other Hyperkinetic Movements

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In autoimmune thyroid disorders, albeit known to affect only 1% of the population, focal or sub-clinical autoimmune thyroid inflammation can be found in around 15% of biochemically euthyroid population [1-3]. Anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) antibodies are considered diagnostic markers of autoimmune thyroid disorders [1]. Neurological manifestations associated with autoimmune thyroid disorders have been frequently under-documented in literature [4], being the most protean amongst these disorders Hashimoto's encephalopathy [5-7]. Spectrum of this disorder an range from subtle behavioral/personality changes to movement disorders, seizures, dementia, encephalopathy, stroke, coma and death [5-8]. Patients can also present with movement disorders without encephalopathy and cognitive impairment [5-7]. There is no pathognomonic clinical, serological, biochemical, electrophysiological or imaging markers [5-7]. In addition, there are no good predictors of treatment response to steroids; [9] in fact, in a recent study [9], only 31% patients completely responded to these drugs. Similarly, in other studies, only 56% and 36% patients with suspected Hashimoto's encephalopathy responded to

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“…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).…”

Section: Discussionmentioning

confidence: 99%

Hashimoto’s Encephalopathy Mimicking Viral Encephalitis: A Case Report

et al. 2020

Front. Neurosci.

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Hashimoto's encephalopathy (HE) is a rare neuropsychiatric syndrome characterized by elevated levels of anti-thyroid antibodies. Diverse manifestations make timely diagnosis of HE difficult. Herein, we report a case of HE, in which the clinical symptoms and laboratory test results mimicked viral encephalitis. A 59-year-old male patient, who presented with a fever, headache, slow and unclear speech, sentence confusion, elevated levels of anti-thyroid antibodies in the serum, an increased white blood cell count, and positivity for anti-thyroid antibodies in the CSF, was finally diagnosed with HE and responded well to a small dose of methylprednisolone. This report helps bring the attention of clinicians to the fact that HE should be considered when cases of unexplained encephalopathy are encountered.

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Opsoclonus as a manifestation of Hashimoto’s encephalopathy

Cited by 13 publications

References 12 publications

Hashimoto encephalopathy: literature review

Hashimoto encephalopathy: literature review

Anti-Thyroid Peroxidase/Anti-Thyroglobulin Antibody-Related Neurologic Disorder Responsive to Steroids Presenting with Pure Acute Onset Chorea

Hashimoto’s Encephalopathy Mimicking Viral Encephalitis: A Case Report

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