Time course of Hashimoto's encephalopathy revealed by MRI: Report of two cases

Chen, Nan; Qin, Wen; Wei, Cuibai; Wang, Xing

doi:10.1016/j.jns.2010.09.019

Cited by 41 publications

(23 citation statements)

References 22 publications

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“…23,25,33 Some of these white matter lesions might have been aging-related, and are therefore non-specific findings. However, several case reports have also shown reversible white matter lesions 25,34,35 or DWI high-intensity spots in subcortical regions 36,37 in HE patients, suggesting that cerebral vasculitis is associated with white matter lesions that are apparently non-specific. Furthermore, we recently demonstrated that serial MRI studies showed expanded and diminished white matter lesions and emerging subcortical high-intensity spots on DWI.…”

Section: Neuroimagingmentioning

confidence: 99%

Hashimoto encephalopathy

Matsunaga

Ikawa

Yoneda

2019

Clinical & Exp Neuroim

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Hashimoto encephalopathy (HE) is an autoimmune encephalopathy associated with autoimmune chronic thyroiditis. The clinical entity and nosology of HE have long been debated. Recently, new autoantibodies associated with autoimmune encephalitis have been discovered. With accumulated reported cases, and our discovery of serum autoantibody against NH2‐terminal of alpha‐enolase as a specific diagnostic marker, HE has been recognized as a distinct clinical entity. The condition appears dominant in females. The clinical features of HE are characterized by various neuropsychiatric symptoms, such as altered consciousness, psychosis and seizures, the presence of serum anti‐thyroid antibodies, normal or non‐specific changes in brain magnetic resonance imaging, diffuse slow wave activities in electroencephalogram and responsiveness to immunotherapy. A few pathological studies showed a lymphocytic infiltration of the small and medium‐sized vessels of the brain, which suggested vasculitis. Non‐specific neurological symptoms, laboratory findings and neuroimaging of HE make its diagnosis an oversight and difficult, whereas antibodies against NH2‐terminal of alpha‐enolase can be useful as a diagnostic biomarker for HE. In this review, we describe the current state of knowledge about HE and discuss progress in the diagnosis of HE.

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Section: Neuroimagingmentioning

confidence: 99%

Hashimoto encephalopathy

Matsunaga

Ikawa

Yoneda

2019

Clinical & Exp Neuroim

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“…Although similar acute ischemic manifestations were observed at the onset of HE in both cases, at follow-up, we observed different evolutions of HE on MRI between the two cases, which might partially account for the diversity of MRI findings (for example, a certain stage of HE). The clinical and MRI findings at follow-up also indicated that early treatment contributed to the recovery of the lesions (28). …”

Section: Diagnosismentioning

confidence: 99%

Hashimoto Encephalopathy: A Rare Intricate Syndrome

Payer¹,

Petrovic²,

Lisý

et al. 2012

Int J Endocrinol Metab

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Recently, several patients have been reported with various signs of encephalopathy and high thyroid antibody levels together with good responsiveness to glucocorticoid therapy. Despite the various clinical presentations, these cases have been termed “Hashimoto encephalopathy” (HE). Although all of the pathogenic components have not yet been clearly elucidated, it is believed that brain vasculitis and autoimmunity directed against common brain-thyroid antigens represent the most likely etiologic pathway. The most common clinical signs include unexplained or epilepsy-like seizures resistant to anti-convulsive treatment, confusion, headaches, hallucinations, stroke-like episodes, coma, impairment of cognitive function, behavioral and mood disturbance, focal neurological deficits, disturbance of consciousness, ataxia, and presenile dementia, together with the presence of high thyroid antibody levels, especially against thyroperoxidase (TPOab). In most cases, the thyroid function is normal or decreased; the thyroid function is rarely increased. The examination of the cerebrospinal fluid, EEG, MRI, SPECT, and neuropsychological examinations are primarily used as diagnostic tools. Most cases showed neural symptoms for months before the acute onset; in some cases, a dramatic acute onset was described. Once the diagnosis is made, corticosteroid treatment usually provides a dramatic recovery. The authors also present a short review of literary cases reported in last decade.

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“…Approximately 50% of all patients with HE demonstrate normal findings on brain computed tomography and MRI, whereas the remainder exhibit nonspecific findings (8). Various diverse neuroradiological findings have been reported in patients with HE, including brain atrophy (9, 10), white matter abnormalities (2), cortical edema (11) and miscellaneous findings (12,13).…”

Section: A C B D E Fmentioning

confidence: 99%

Steroid-responsive Thalamic Lesions Accompanying Microbleeds in a Case of Hashimoto's Encephalopathy with Autoantibodies Against α-enolase

et al. 2013

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A 67-year-old man receiving antithrombotic therapy developed rapidly progressive amnesia. T2-weighted images of brain MRI revealed hyperintense lesions in the bilateral thalami accompanied by microbleeds. Antithyroglobulin antibodies and autoantibodies against the N-terminal of α-enolase (NAE) were identified in the patient's serum; therefore, Hashimoto's encephalopathy (HE) was suspected. Although the patient's radiological findings improved following steroid therapy, his symptoms did not improve, possibly due to increased thalamic microbleeds. Because anti-NAE antibodies are possibly associated with vasculitis, HE accompanied by anti-NAE antibodies may be exacerbated by microbleeds in patients receiving antithrombotic therapy.

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Time course of Hashimoto's encephalopathy revealed by MRI: Report of two cases

Cited by 41 publications

References 22 publications

Hashimoto encephalopathy

Hashimoto encephalopathy

Hashimoto Encephalopathy: A Rare Intricate Syndrome

Steroid-responsive Thalamic Lesions Accompanying Microbleeds in a Case of Hashimoto's Encephalopathy with Autoantibodies Against α-enolase

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