Querol Pascual M R, Aguirre Sánchez J J, Velicia Mata M R, Gahete Jiménez C, Durán Herrera M C, González Dorrego F
Sección de Neurología, Hospital Universitario Infanta Cristina, Badajoz.
Neurologia. 2000 Aug-Sep;15(7):313-6.
Hashimoto's encephalopathy is a poor understood neurological disorder associated with thyroid disease. We describe a 12 years old woman with a relapsing clinical picture characterized by acute onset confusion, tremor, convulsive seizures and a stroke-like episode associated with autoimmune thyroid disease. High titers of antithyroid antibodies were detected in her serum. Neurologic investigation showed a marked slowing of the basic activity in EEG, diminished perfusion of left hemisphere in brain SPECT, mild CSF protein level without pleocytosis, and normal brain CT and cerebral angiogram. The clinical course was favorable without corticosteroid therapy. Antithyroid antibodies and EEG were normal after one-year follow-up. We suggest that antithyroid antibody levels should be checked in any unexplained acute or subacute encephalopathy, especially when a relapsing course, stroke-like exacerbation, seizures, tremor or elevation of the CSF protein are found.
桥本脑病是一种了解甚少的与甲状腺疾病相关的神经障碍。我们描述了一名12岁女性，其临床症状反复出现，特点为急性起病的意识模糊、震颤、惊厥发作以及与自身免疫性甲状腺疾病相关的类似中风发作。在她的血清中检测到高滴度的抗甲状腺抗体。神经学检查显示脑电图基本活动明显减慢，脑单光子发射计算机断层扫描（SPECT）显示左半球灌注减少，脑脊液蛋白水平轻度升高但无细胞增多，脑部CT和脑血管造影正常。未经皮质类固醇治疗，临床病程良好。一年随访后抗甲状腺抗体和脑电图正常。我们建议，对于任何不明原因的急性或亚急性脑病，尤其是发现有反复病程、类似中风的加重、癫痫发作、震颤或脑脊液蛋白升高时，都应检查抗甲状腺抗体水平。
