Effects of prednisone and plasma exchange on cognitive impairment in Hashimoto encephalopathy

Hussain, Naaz; Rumbaugh, J.; Kerr, Douglas A.; Nath, Anand; Hillis, Argye E.

doi:10.1212/01.wnl.0000148580.98997.c5

Cited by 51 publications

(35 citation statements)

References 2 publications

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“…Focal spikes were reported in a confused and paranoid patient who had no seizures [17]. Periodic lateralized epileptiform discharges (PLEDs), frontal intermittent rhythmic theta-delta activity (FIRTA, FIRDA) were observed in four patients (two with seizures) who had normal brain CT or brain MRI findings [38,44,58]. Despite the sometime striking similarity to CJD, periodic triphasic waves were never recorded.…”

Section: Eeg Findingsmentioning

confidence: 97%

“…Dementia, depression, cerebellar symptoms, pyramidal symptoms and extrapyramidal symptoms are typical of the progressive variety of HE. The cognitive decline differs according to the age of patients [2,8,10,18,19,21,22,23,26,27,30,31,33,34,37,38,39,44,45,49,55,57,60,61,66,68,70,72,73,77,84,88]: children are described as badly performing at school, showing learning difficulties or poor concentration [49,84,88], whereas adult patients can suffer a memory impairment as well as progressive aphasia or apraxia. In one case, the severity of symptoms was such that the patient was given a diagnosis of Alzheimer's disease [33].…”

Section: Clinical Symptomsmentioning

confidence: 99%

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The neurological disorder associated with thyroid autoimmunity

2006

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The neurological disorder associated with thyroid autoimmunity is an elusive disease that neurologists have learned to recognize in the last few years. The diagnosis is made, after excluding more common diseases, when neuropsychiatric symptoms develop in a patient with high serum concentrations of anti-thyroid antibodies. The clinical presentations of the disease and the many controversial issues surrounding the diagnosis, the pathogenesis, the role of thyroid autoantibodies, and the choice of therapy are reviewed and discussed in the light of the medical literature in English.

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Section: Eeg Findingsmentioning

confidence: 97%

Section: Clinical Symptomsmentioning

confidence: 99%

The neurological disorder associated with thyroid autoimmunity

2006

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“…Patients with HE typically respond to high-dose steroid therapy with favorable outcomes (5,17). A report reviewing 85 cases of HE found 96% of patients improved in neurologic function after such treatment (8).…”

Section: Discussionmentioning

confidence: 99%

“…A report reviewing 85 cases of HE found 96% of patients improved in neurologic function after such treatment (8). In rare instances, plasmapheresis has been used to reverse the autoimmune effects, especially when the clinical condition was severe, not responsive to steroid therapy, or recurred as steroids were tapered (3,17). HE has a tendency to recur after initial treatment and patients often require lifelong maintenance steroid therapy to avoid relapse.…”

Section: Discussionmentioning

confidence: 99%

Hashimoto’s Encephalopathy After Intensive Lymphocyte Depletion With Rabbit Anti-thymocyte Globulin in a Renal Transplant Patient

Stevens

Wakefield

Alonso

et al. 2008

American Journal of Transplantation

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There has been no reported case of Hashimoto's encephalopathy (HE) ('steroid-responsive encephalopathy associated with autoimmune thyroiditis', 'SREAT'), in the renal transplant recipient population. We describe the case of a 55-year-old female with Type-1 diabetes who presented 2 years posttransplantation in a comatose state that had developed over the preceding 24 h. The patient had received a short, intensive course of rATG induction at the time of transplantation and early steroid withdrawal. After 6 months she had been withdrawn from calcineurin inhibitors and was maintained on mycophenolate mofetil and sirolimus. Systematic workup determined the cause of her coma to be HE. High-dose steroid therapy resulted in complete resolution of the patient's symptoms. The literature regarding the diagnosis, course and treatment of HE is reviewed and the possibility that increased use of steroid-free immunosuppression and intensive lymphocyte depletion regimens may increase the prevalence of de novo autoimmune disease is discussed.

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“…Man vermutet eine Kreuzreaktion zwischen Oberflächenantigenen der Schilddrüse und ZNS-Strukturen [15]. Das Vorhandensein antineuronaler Autoantikörper wurde ebenfalls beschrieben [24,32].…”

Section: Schilddrüse N Hyperthyreose Und Thyroxinintoxikationunclassified

Schilddrüse, Nebenschilddrüse und Epilepsie

Rosenow

Reis

2006

Z. Epileptol.

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Thyroid, parathyroid glands and epilepsy" Abstract There is clinical evidence that endogenous (hyperthyroidism) as well as exogenous thyroxin intoxications can provoke seizures or increase seizure frequency and intensity. The latter was reported particularly for juvenile myoclonic epilepsy (JME). Hypothyroidism, on the other hand, is associated with a decreased incidence of febrile seizures. Hashimoto-encephalopathy occurs in patients with Hashimoto-thyroiditis and is a usually steroid responsive, at times spontaneously remitting, encephalopathy. Epileptic seizures occurring in 50-60%, myoclonus psychotic or confusional states and changes in the level of consciousness are frequent neuro-psychiatric symptoms. Hypoparathyroidism, usually of iatrogenic etiology, frequently presents with tetany occurring within days or weeks of the operation. However, epileptic seizures were reported in 25-30% of the cases and can emerge months to years after the operation.

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Effects of prednisone and plasma exchange on cognitive impairment in Hashimoto encephalopathy

Cited by 51 publications

References 2 publications

The neurological disorder associated with thyroid autoimmunity

The neurological disorder associated with thyroid autoimmunity

Hashimoto’s Encephalopathy After Intensive Lymphocyte Depletion With Rabbit Anti-thymocyte Globulin in a Renal Transplant Patient

Schilddrüse, Nebenschilddrüse und Epilepsie

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