Hashimoto Encephalopathy Presenting With Stroke-Like Episodes in an Adolescent Female: A Case Report and Literature Review

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• 作者：Brett R. Graham ; MD^a ; ^{brett.graham@usask.ca" class="auth_mail" title="E-mail the corresponding author} ; Natalie Shiff ; MD^b ; Munier Nour ; MD^c ; Simona Hasal ; MD^d ; Richard Huntsman ; MD^d ; Salah Almubarak ; MD^d
• 关键词：Hashimoto encephalopathy ; stroke ; steroid-responsive encephalopathy ; autoimmune encephalopathy ; autoimmune thyroiditis
• 刊名：Pediatric Neurology
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：59
• 期：Complete
• 页码：62-70
• 全文大小：1706 K

文摘

Hashimoto encephalopathy is a rare form of encephalopathy thought to be of autoimmune etiology. Cognitive changes and seizures are the most commonly reported presenting manifestation. Stroke-like episodes have also been documented in these individuals. We describe a rare adolescent with Hashimoto encephalopathy who presented with stroke-like symptoms.

Patient Description

A previously well 15-year-old girl experienced sudden-onset language disturbance and right hemiparesis. Her symptoms resolved, but weeks later, she began experiencing refractory seizures, episodes of status epilepticus, and cognitive decline. An extensive evaluation was unremarkable, but thyroid peroxidase antibodies were elevated, and a diagnosis of Hashimoto encephalitis was made. Steroid therapy was initiated, and her symptoms resolved with return to baseline cognitive function.

Conclusion

Hashimoto encephalopathy is a highly treatable condition that may be considered in the differential diagnosis of children and adolescents presenting with stroke-like symptoms.