Journal of Pediatric Epilepsy 2015; 04(02): 080-084
DOI: 10.1055/s-0035-1555598
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Relapsing–Remitting Encephalopathy with Status Epilepticus: Think Hashimoto Encephalopathy

Serdal Güngör
1   Department of Pediatric Neurology, Faculty of Medicine, İnönü University, Malatya, Turkey
,
Sabiha G. Raif
1   Department of Pediatric Neurology, Faculty of Medicine, İnönü University, Malatya, Turkey
› Author Affiliations
Further Information

Publication History

08 December 2013

06 September 2014

Publication Date:
31 July 2015 (online)

Abstract

Hashimoto encephalopathy is a rare syndrome in children with nonspecific clinical symptoms, which leads to underdiagnosis. Encephalopathy with a high thyroperoxidase antibody levels and exclusion of other causes can provide a diagnosis unrelated to thyroid hormone status. An acute, subacute, chronic, progressive, or relapsing–remitting course can be seen. The main therapy for Hashimoto encephalopathy is steroid administration, which lends its other name as steroid-responsive encephalopathy associated with autoimmune thyroiditis. However, there are few cases with spontaneous remission without steroid therapy. Here, we report a case with a relapsing course but spontaneous remission.

 
  • References

  • 1 Brain L, Jellinek EH, Ball K. Hashimoto's disease and encephalopathy. Lancet 1966; 2 (7462) 512-514
  • 2 Santoro D, Colombo I, Ghione I , et al. Steroid-responsive Hashimoto encephalopathy mimicking Creutzfeldt-Jakob disease. Neurol Sci 2011; 32 (4) 719-722
  • 3 Chang T, Riffsy MT, Gunaratne PS. Hashimoto encephalopathy: clinical and MRI improvement following high-dose corticosteroid therapy. Neurologist 2010; 16 (6) 394-396
  • 4 Chen N, Qin W, Wei C, Wang X, Li K. Time course of Hashimoto's encephalopathy revealed by MRI: report of two cases. J Neurol Sci 2011; 300 (1-2) 169-172
  • 5 Berger I, Castiel Y, Dor T. Paediatric Hashimoto encephalopathy, refractory epilepsy and immunoglobulin treatment—unusual case report and review of the literature. Acta Paediatr 2010; 99 (12) 1903-1905
  • 6 Schiess N, Pardo CA. Hashimoto's encephalopathy. Ann N Y Acad Sci 2008; 1142: 254-265
  • 7 Castillo P, Woodruff B, Caselli R , et al. Steroid-responsive encephalopathy associated with autoimmune thyroiditis. Arch Neurol 2006; 63 (2) 197-202
  • 8 Zhao W, Li J, Wang J , et al. A case of Hashimoto encephalopathy: clinical manifestation, imaging, pathology, treatment, and prognosis. Neurologist 2011; 17 (3) 141-143
  • 9 Muhle H, van Baalen A, Riepe FG, Rohr A, Stephani U. Hashimoto encephalopathy in a 15-year-old-girl: EEG findings and follow-up. Pediatr Neurol 2009; 41 (4) 301-304
  • 10 Castro-Gago M, Gómez-Lado C, Maneiro-Freire M, Eirís-Puñal J, Bravo-Mata M. Hashimoto encephalopathy in a preschool girl. Pediatr Neurol 2010; 42 (2) 143-146
  • 11 Blanchin S, Coffin C, Viader F , et al. Anti-thyroperoxidase antibodies from patients with Hashimoto's encephalopathy bind to cerebellar astrocytes. J Neuroimmunol 2007; 192 (1-2) 13-20
  • 12 Alink J, de Vries TW. Unexplained seizures, confusion or hallucinations: think Hashimoto encephalopathy. Acta Paediatr 2008; 97 (4) 451-453
  • 13 Podberezin M, Meriggioli MN, Locante A, Voros A, Valyi-Nagy T, Kajdacsy-Balla A. Hashimoto encephalopathy with fulminant myocarditis. Pathol Res Pract 2010; 206 (10) 720-722
  • 14 Aquino RT, Mutarelli EG. Hashimoto's encephalopathy. Arq Neuropsiquiatr 2009; 67 (3A): 724-725