Hashimoto ’s Encephalopathy: Case Series and Literature Review

AbstractPurpose of ReviewTo describe the clinical manifestations of Hashimoto ’s encephalopathy (HE) and discuss its pathogenesis in light of recent research.Recent FindingsThe pathogenesis of HE is uncertain. Available evidences point towards an autoimmune etiology due to vasculitis or other inflammatory process. Detection of thyroid antibodies — antithyroid peroxidase and anti-thyroglobulin are essential for diagnosis. Autoimmune encephalitis including Anti-IgLON5 disease needs to be excluded in suspected cases with appropriate tests for neuronal surface antibodies. Detection of thyroid autoantibodies is nonspecific, as these can be det ected in some normal individuals and in other autoimmune diseases. In recent years, attention has turned to an aggressive form of Hashimoto’s thyroiditis accompanied by elevated serum IgG4 levels in younger males with very high levels of thyroid antibodies. The role of the thyroid autoantibodies i n the central nervous system (CNS) tissue damage remains unclear and these can act only as markers for diagnosis. Conversely, they have a role to play in determining the thyroid pathology — more glandular fibrosis associated with thyro-peroxidase antibody than with the thyroglobulin antibody.SummaryHE is a syndrome characterized by altered mental status, confusion, hallucinations, delusions, and sometimes seizures, in association with high serum anti-thyroid antibody concentration that is usually responsive to glucocorticoid therapy. Diagno...

Source: Current Neurology and Neuroscience Reports - February 28, 2023 Category: Neuroscience Source Type: research