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Fortschr Neurol Psychiatr 2008; 76(10): 610-615
DOI: 10.1055/s-2008-1038253
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© Georg Thieme Verlag Stuttgart · New York

Hashimoto-Enzephalopathie – Eine schwierige Differenzialdiagnose

Ein Fallbericht reversibler Demenz und PsychoseHashimoto Encephalopathy – A Difficult Differential DiagnosisA Case Report of Reversible Dementia and PsychosisChristina  Nunnemann1 , T.  Kratz1
  • 1Evangelisches Krankenhaus Königin Elisabeth Herzberge, Abt. für Psychiatrie, Psychotherapie und Psychosomatik (Prof. Dr. A. Diefenbacher), Berlin
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Publication Date:
02 October 2008 (online)

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Zusammenfassung

Einleitung: Die Hashimoto-Enzephalopathie ist eine seltene Erkrankung, bei der eine Demenz, Verwirrtheitszustände und epileptische Anfälle ebenso wie weitere neurologische Symptome auftreten können. Es besteht eine Assoziation zur Hashimoto-Thyreoiditis. Fallbericht: Wir berichten über eine 74-jährige Patientin, die bei einer Hashimoto-Enzephalopathie neurologische und psychiatrische Störungen wie epileptische Anfälle, psychotisches Erleben, kognitive Defizite, Rigor, Tremor und visuelle Halluzinationen sowie fluktuierende Verwirrtheitszustände zeigte. Nach einer Kortikosteroidtherapie bildeten sich die Symptome vollständig zurück. Ergebnis: Der vorliegende Fall zeigt, dass bei Auftreten einer Psychose in Kombination mit einem demenziellen Syndrom und weiteren neurologischen Symptomen auch an eine Hashimoto-Enzephalopathie gedacht werden und dann eine Abgrenzung zur Lewy-Body-Demenz und zur Creutzfeldt-Jakob-Erkrankung erfolgen sollte.

Abstract

Introduction: Hashimoto encephalopathy is a rare disease that is associated with Hashimoto thyreoiditis. Dementia, disturbances of consciousness and epileptic seizures are the most common features. Case report: We report a case of Hashimoto encephalopathy in a 74-year-old woman who presented with psychotic episodes, visual hallucinations, dementia, tremor, rigidity and fluctuation of consciousness. After treatment with steroids, cognitive function became normal and other symptoms improved significantly. Conclusion: Hashimoto encephalopathy should be considered as a differential diagnosis of psychosis in combination with dementia and other neurological symptoms to dementia with Lewy bodies and Creutzfeldt-Jakob disease.

Schlüsselwörter

Hashimoto-Enzephalopathie - Demenz mit Lewy-Bodies - Creutzfeldt-Jakob-Erkrankung

Key words

Hashimoto encephalopathy - dementia with Lewy bodies - Creutzfeldt-Jakob disease

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Dr. med. Torsten Kratz

Evangelisches Krankenhaus Königin Elisabeth Herzberge KEH, Abt. für Psychiatrie, Psychotherapie und Psychosomatik, Funktionsbereich Gerontopsychiatrie und -psychotherapie

Herzbergstr. 79

10365 Berlin

Email: T.Kratz@keh-berlin.de