Hashimoto’s encephalopathy: a rare pediatric brain disease

Abstract

We report a 9-year-old female who presented with new onset intractable seizure activity followed by a prolonged encephalopathic state. After ruling out common etiologies, Hashimoto's encephalopathy (HE) was considered, and antibody levels to thyroid peroxidase and thyroglobulin were both markedly elevated in her serum. She was euthyroid at the time of presentation. Upon treatment with high dose methylprednisolone, the patient demonstrated a significant improvement in her encephalopathy. The diagnosis of HE requires strong clinical suspicion with evidence of antithyroid antibodies, as well as an encephalopathy not explained by another etiology. While well documented in the adult literature, only a handful of pediatric cases have been described to date. Patients with HE have a nearly universal response to high dose glucocorticoids. HE should be considered in the differential diagnosis of any patient, adult or pediatric, who displays prolonged, unexplainable encephalopathy.

An unusual case of steroid unresponsive Hashimoto’s encephalitis in Indian under-5

“…Being a rare disease even in adults, the incidence and prevalence in children are not well known [1,5,6]. To the best of our knowledge, this is the first case report of refractory HE in an Indian child of under 5 years of age receiving plasma exchange to date.…”

An Unusual Cause of Frequent, Sudden, Transient, Unexplained Falls and New-Onset Status Epilepticus: Case Report and Mini-Review

“…In addition, oral olanzapine, risperidone, ziprasidone, and intravenous haloperidol have been used in the treatment of agitation and aggression during the course of the illness. 24,25,29,33,35,36,41…”

“…All these abnormalities return to normal or decreased with treatment. 24,25,29,[33][34][35][36] Future multicenter studies are needed to study the sensitivity and specificity of these antibodies in diagnosing HE.…”

New-Onset Status Epilepticus in an 11-year-old Patient with Thyroid Autoimmune Dysfunction: A Case Report of Pediatric Hashimoto Encephalopathy

“…1 HE is considered a rare condition in children and its diagnosis is made by exclusion of other potential causes. 2 We present a particular case of an 11-year-old girl presenting with new-onset refractory status epilepticus (NORSE) as the main feature of HE.…”