van Oostrom J C, Schaafsma A, Haaxma R
Academisch Ziekenhuis, afd. Neurologie, Groningen.
Ned Tijdschr Geneeskd. 1999 Jun 19;143(25):1319-22.
Two women (aged 12 and 32 years) and a man aged 40 years presented with fluctuating confusional states, depressed level of consciousness, seizures and tremor or myoclonic activity; hallucinations occurred in two of them. Laboratory examinations showed antibodies to thyroid peroxidase in serum, elevated protein levels in CSF and normal cerebral MRI. The EEG findings were indicative of diffuse encephalopathy. Hashimoto's encephalopathy was diagnosed. One patient improved dramatically on prednisone therapy, the other two patients recovered spontaneously. Hashimoto's encephalopathy is a subacute, fluctuating encephalopathy with combinations of impaired level of consciousness, involuntary movements, and epileptic or psychiatric symptoms. It occurs in patients with antithyroid antibodies. It is important to consider this diagnosis, since some patients may benefit from treatment with corticosteroids.
两名女性（年龄分别为12岁和32岁）以及一名40岁男性出现意识状态波动、意识水平下降、癫痫发作和震颤或肌阵挛活动；其中两人出现幻觉。实验室检查显示血清中存在甲状腺过氧化物酶抗体，脑脊液蛋白水平升高，脑部MRI正常。脑电图结果提示弥漫性脑病。诊断为桥本脑病。一名患者接受泼尼松治疗后显著改善，另外两名患者自发康复。桥本脑病是一种亚急性、波动性脑病，伴有意识水平受损、不自主运动以及癫痫或精神症状。它发生于抗甲状腺抗体阳性的患者。考虑到一些患者可能从皮质类固醇治疗中获益，做出这一诊断很重要。
