Myelopathy associated with Hashimoto's disease

The neurological disorder associated with thyroid autoimmunity

“…Pyramidal signs were observed in 25 patients [3, 5, 8, 9, 13, 21, 30, 34-37, 42, 43, 60, 62, 65, 69, 72, 85, 87]. Three patients presented a myelopathy without encephalopathy and had normal spinal MRI findings [3,30,71]. In one of them, the symptoms of acute encephalopathy were observed during the clinical relapse after steroid therapy [3].…”

“…Some patients were described because of their reversible MRI findings. Serial brain MRI produced different results: the disappearance of subcortical hyperintensities paralleling the clinical improvement in one patient [9], a modification of the size and distribution of lesions without clinical correlates in one patient [77], and initially normal findings, even in the acute stage of HE, replaced by subcortical hyperintensities, in three patients [3,19,49]. Isik described a patient with seizures, cognitive decline, psychosis and hallucinations.…”

“…Three patients presented a myelopathy without encephalopathy and had normal spinal MRI findings [3,30,71]. In one of them, the symptoms of acute encephalopathy were observed during the clinical relapse after steroid therapy [3]. In six patients HE was considered the cause of a cerebellar syndrome [4,18,31,62,74,80].…”

“…In 16 patients CSF analysis revealed the presence of anti-thyroid antibodies [3,26,29,30,33,72,78]. In 10 patients autoantibodies were searched for in the CSF and were not found [49,68,72,78].…”

Hashimoto's encephalopathy: epidemiologic data and pathogenetic considerations

“…HE is a protean condition that can either remit spontaneously or after corticosteroids. At the moment, HE is suspected whenever symptoms of acute or subacute encephalopathy or myelopathy [3] are associated with high serum levels of anti-thyroid antibodies. HE remains a quite elusive nosologic entity and this may account for the lack of epidemiologic data.…”