Hashimoto’s encephalopathy masquerading as acute psychosis

Wilcox, Rachel; To, Trinh T.; Koukourou, A.; Frasca, Joseph

doi:10.1016/j.jocn.2006.10.019

Cited by 26 publications

(25 citation statements)

References 14 publications

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“…The most important laboratory finding of HE is EEG abnormalities which reach up to 98%, and especially presence of diffuse slaw waves (24). Another characteristic of HE, as it would be observe in other case reports in the literature, is that it responds treatment rapidly and dramatically (6,22). In our case, no abnormality in EEG, no signs such as epileptic seizures, myoclonus, and ataxia, and dramatic responsiveness of our case to thyroid replacement treatment helped us to rule out HE easily.…”

Section: Discussionmentioning

confidence: 84%

“…Another important diagnosis which should be differentiated in concomitance of Hashimoto thyroiditis and psychiatric symptoms is Hashimoto Encephalitis (HE), which is commonly come across in the literature (6,21,22). Myoclonus, epileptic seizures, fluctuations in consciousness, ataxia, dementia, and psychotic symptoms are also frequently encountered in HE (23).…”

Section: Discussionmentioning

confidence: 99%

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Psychosis related with Hashimoto thyroiditis: a case report

Ağaçhanlı¹,

Balaban²,

Yazar³

et al. 2016

Dusunen Adam

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Psychosis related with Hashimoto thyroiditis: a case reportHashimoto's thyroiditis is an autoimmune disease characterized with inflammation of the thyroid gland.Psychiatric symptoms frequently accompany Hashimoto's thyroiditis. Major depression is the most common affective disorder with the prevalence of 33-43%. Psychotic disorders may accompany at 5% rate. In this case report; a patient, recently diagnosed with hypothyroidism and involved into a psychotic process due to his hypothyroidism, is discussed. The patient's refusal of oral intake and lack of parenteral preparation of thyroxine in our country were the factors that made the treatment more complicated. The aim of this case report is to emphasize the importance of the routine laboratory examinations especially during the first admission to the hospital, and to underline difficulty of thyroid replacement therapy due to lack of preparation of parenteral thyroxine in our country in patients who do not or can not get medications orally.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Psychosis related with Hashimoto thyroiditis: a case report

Ağaçhanlı¹,

Balaban²,

Yazar³

et al. 2016

Dusunen Adam

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“…4 Although this condition is rare and its clinical manifestations are nonspecific, it should be included in the differential diagnosis of neuropsychiatric disorders in elderly patients, especially in association with APS.…”

mentioning

confidence: 99%

Calibrated finger rub auditory screening test (CALFRAST)

Torres-Russotto¹,

Landau²,

Harding³

et al. 2009

Neurology

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with APS and have even been found in 27% of patients with APS.5 SREAT may occur in the absence of thyroid function abnormalities; MRI can be normal or reveal the presence of diffuse white matter changes, atrophy, or ischemic lesions.Similar to APS, SREAT is responsive to steroid therapy. 4 Although this condition is rare and its clinical manifestations are nonspecific, it should be included in the differential diagnosis of neuropsychiatric disorders in elderly patients, especially in association with APS.K. Smida-Rynkowska, M.R. Belabed, M. Rynkowski, M. Vokaer, J.C. Bier, Brussels, Belgium Disclosure: The authors report no disclosures.Reply from the Authors: We thank SmidaRynkowska et al. for their comments and agree that SREAT should be considered as a differential diagnosis of neuropsychiatric disorders. This diagnosis was included in our patient but antithyroid antibodies were negative in serum and in CSL.Furthermore, our patient had a history of venous thrombosis, which is not usually associated with isolated SREAT. Thyroiditis encephalopathy is known to have good response to steroids, but this is very unusual in neuropsychiatric symptoms related to a primary APS.

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“…[1] Florid neuropsychiatric manifestations as the initial symptom have been reported. [4] Our case 1 had rapid evolution of encephalopathy that led to suspicion of Creutzfeldt-Jakob disease, limbic encephalitis, neurosyphilis, central nervous system vasculitis and HIV encephalopathy. However, all these disorders could be excluded by investigations.…”

Section: Discussionmentioning

confidence: 98%

Steroid-responsive encephalopathy in autoimmune thyroiditis: Clinical spectrum and MRI observations in three cases

Dinkar

Sinha

Taly

et al. 2011

Ann Indian Acad Neurol

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Hashimoto's encephalopathy (H.E.) is probably of autoimmune etiology, and manifests with seizures, stroke-like episodes, cognitive decline, neuropsychiatric symptoms, myoclonus. It is presumed to be autoimmune in origin with high serum titers of antithyroid peroxidase antibodies (anti-TPA). Thyroid function might often be normal. The diagnosis is arrived at by excluding other toxic, metabolic and infectious causes of encephalopathies, supportive clinical profile, elevated thyroid antibodies and optimum steroid response. We present the characteristic phenotypic manifestations, magnetic resonance imaging and electroechography observations and response to immunomodulation with follow-up in three cases of H.E. All the three cases manifested with subacute to chronic progressive encephalopathy, cerebellar dysfunction, seizures, behavioral abnormalities and oculomotor disturbances and had evidence of hypothyroidism, elevated titers of anti-TPA and positive thyroid anti-microsomal antibodies. Atypical and uncommon presentations are known. This report emphasizes that a high index of suspicion is often required in cases with “investigation negative encephalopathy” for early diagnosis of H.E.

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Hashimoto’s encephalopathy masquerading as acute psychosis

Cited by 26 publications

References 14 publications

Psychosis related with Hashimoto thyroiditis: a case report

Psychosis related with Hashimoto thyroiditis: a case report

Calibrated finger rub auditory screening test (CALFRAST)

Steroid-responsive encephalopathy in autoimmune thyroiditis: Clinical spectrum and MRI observations in three cases

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