Hashimoto's encephalopathy : epidemiology, pathogenesis and management.

摘要: Hashimoto's encephalopathy is a term used to describe an of presumed autoimmune origin characterised by high titres antithyroid peroxidase antibodies. In similar fashion thyroid disease, more common in women than men. It has been reported paediatric, adult and elderly populations throughout the world. The clinical presentation may involve relapsing remitting course include seizures, stroke-like episodes, cognitive decline, neuropsychiatric symptoms myoclonus. Thyroid function usually clinically biochemically normal.Hashimoto's appears be rare disorder, but, as it responsive treatment with corticosteroids, must considered cases 'investigation negative encephalopathies'. Diagnosis made first instance excluding other toxic, metabolic infectious causes neuroimaging CSF examination. Neuroimaging findings are often not helpful clarifying diagnosis. Common differential diagnoses when these conditions excluded Creutzfeldt-Jakob rapidly progressive dementias, paraneoplastic nonparaneoplastic limbic encephalitis. context typical picture, antibodies, particular diagnostic. These however, can detected elevated healthy general population. Treatment corticosteroids almost always successful, although relapse occur if this ceased abruptly. Other forms immunomodulation, such intravenous immune-globulin plasma exchange, also effective. Despite link aetiology unknown. likely that antibodies pathogenic, but marker response. Pathological suggest inflammatory process, features severe vasculitis absent. links between pictures, auto-antibody pattern brain pathology await further clarification through research. will subsumed into group nonvasculitic meningoencephalopathies. This disorders encephalitis associated voltage-gated potassium channel Some authors have suggested abandoning any Hashimoto renaming condition 'steroid thyroiditis' better reflect current, limited, understanding condition.