RSS-Feed abonnieren
DOI: 10.1055/s-2002-32364
Georg Thieme Verlag Stuttgart · New York
Hashimoto Encephalopathy - is it Underdiagnosed in Pediatric Patients?
Publikationsverlauf
Publikationsdatum:
20. Juni 2002 (online)
![](https://www.thieme-connect.de/media/neuropediatrics/200202/lookinside/thumbnails/10.1055-s-2002-32364-1.jpg)
Abstract
Hashimoto encephalopathy (HE) is associated with Hashimoto thyroiditis. Clinically it presents with variable symptoms like seizures, neuropsychiatric changes or focal neurological deficits. Autoimmune phenomena are hypothesized for the pathogenesis. HE has mainly been described in the adult population. We present two 14-year-old patients who presented with recurrent seizures and mental decline. SPECT and PET scans showed distinctly pathological changes. Both patients were diagnosed with HE and improved dramatically on steroids. We feel that HE is a rare but important differential diagnosis of encephalopathy also in the pediatric population. As this disease responds well to steroids, we recommend to obtain basic thyroid function tests as well as thyroid antibodies in all cases of unexplained encephalopathy or unexplained status epilepticus.
Key words
Hashimoto Encephalopathy - Children - Hashimoto Thyroiditis - Status Epilepticus - Thyroid Antibodies
References
- 1 Balestri P, Grosso S, Garibaldi G. Alternating hemiplegia of childhood or Hashimoto's encephalopathy?. J Neurol Neurosurg Psych. 1999; 66 548-549
- 2 Brain L, Jellinek E H. Hashimoto disease and encephalopathy. Lancet. 1966; 2 512-514
- 3 Byrne O C, Zuberi S M, Madigan C A, King M D. Hashimoto's thyroiditis - a rare but treatable cause of encephalopathy in children. Eur J Paediatr Neurol. 2000; 4 279-282
- 4 Dayan C M, Daniels G H. Chronic autoimmune thyroiditis. N Engl J Med. 1996; 335 99-107
- 5 Forchetti C M, Katsamakis G, Garron D C. Autoimmune thyroiditis and a rapidly progressive dementia: Global hypoperfusion on SPECT scanning suggests a possible mechanism. Neurology. 1997; 49 623-626
- 6 Gucuyener K, Serdaroglu A, Bideci A, Yazman Y, Soysal A S, Cinaz P J. Tremor and myoclonus heralding Hashimoto's encephalopathy. J Pediatr Endocrinol Metab. 2000; 13 1137-1141
- 7 Hernandez Echebarria L E, Saiz A, Graus F, Tejada J, Garcia J M, Clavera B, Fernandez F. Detection of 14-3-3 protein in the CSF of a patient with Hashimoto's encephalopathy. Neurology. 2000; 54 1539-1540
- 8 Kothbauer-Margreiter I, Sturzenegger M, Komor J, Baumgartner R, Hess C W. Encephalopathy associated with Hashimoto thyreoiditis: Diagnosis and treatment. J Neurol. 1996; 243 585-593
- 9 McCabe D JH, Burke T, Connolly S, Hutchinson M. Amnesic syndrome with bilateral mesial temporal lobe involvement in Hashimoto's encephalopathy. Neurology. 2000; 54 737-739
- 10 Querol Pascual M R, Aguirre Sanchez J J, Velicia Mata M R, Gahete Jimenez C, Duran Herrera M C, Gonzalez Dorrego F. Hashimoto's encephalitis: a new case with spontaneous remission. Neurologia. 2000; 15 313-316
- 11 Rallison M L, Dobyns B M, Keating F R, Rall J E, Tyler F H. Occurrence and natural history of chronic lymphocytic thyroiditis in childhood. J Pediatr. 1975; 86 675-682
- 12 Seipelt M, Zerr I, Nau R, Mollenhauer B, Kropp S, Steinhoff B J. et al . Hashimoto's encephalitis as a differential diagnosis of Creutzfeldt-Jakob disease. Neurol Neurosurg Psych. 1999; 66 172-176
- 13 Shaw P J, Walls T J, Newman P K, Cleland P G, Cartlidge N EF. Hashimoto encephalopathy: a steroid-responsive disorder associated with high anti-thyroid antibody titers, report of 5 cases. Neurology. 1991; 41 228-233
- 14 Shein M, Apter A, Dickerman Z, Tyano S, Gadoth N. Encephalopathy in compensated Hashimoto thyroiditis: a clinical expression of autoimmune cerebral vasculitis. Brain Dev. 1986; 8 60-64
- 15 Sybesma C A, v Pinxteren-Nagler E, Sinnige L G, van Oostrom J C, de Vries T W. Hashimoto encephalopathy in a 12-year-old girl. Eur J Pediatr. 1999; 158 867-868
- 16 Takahashi S, Mitamura R, Itoh Y, Suzuki N, Okuno A. Hashimoto encephalopathy: etiologic considerations. Pediatr Neurol. 1994; 11 328-331
- 17 Vasconcellos E, Pina-Garza J, Fakhoury T, Fenichel G. Pediatric manifestations of Hashimoto's encephalopathy. Pediatr Neuro. 1999; 20 394-398
- 18 Watemberg N, Willis D, Pellock J M. Encephalopathy as the presenting symptom of Hashimoto's thyroiditis. J Child Neurol. 2000; 15 66-69
Prof. Dr. R. Korinthenberg
Department of Neuropediatrics, University Children's Hospital
Mathildenstr. 1
79106 Freiburg
Germany
eMail: rudokori@kikli.ukl.uni-freiburg.de