Nakamura Harumasa, Tokonami Fusao, Yamasaki Masahiro
Department of Neurology, Hamamatsu Rousai Hospital.
Rinsho Shinkeigaku. 2002 Feb;42(2):162-6.
We report a patient with Hashimoto's encephalopathy who showed remission and exacerbation 2 times, with a review of previously reported patients in Japan. A 54-year-old woman was admitted to our hospital for various symptoms, such as tremors of the bilateral upper limbs, psychiatric symptoms, consciousness disorder, and convulsion. Steroid pulse therapy and the subsequent oral maintenance therapy resulted in remission. There was no relapse. The patient was positive for anti-thyroid antibody. Electroencephalography showed diffuse slow waves. The responsiveness to steroids suggested Hashimoto's encephalopathy. According to previous studies, clinical symptoms, magnetic resonance imaging (MRI) findings, and the responsiveness to steroids are similar among steroid-reactive encephalopathy, non-herpetic limbic encephalitis, and Hashimoto's encephalopathy. Anti-thyroid antibody levels characteristically increased in patients with Hashimoto's encephalopathy. However, measurement of this parameter in patients with these diseases is rare. In patients with idiopathic encephalopathy/encephalitis, anti-thyroid antibody levels should be measured to facilitate accurate diagnosis.
我们报告了一名桥本脑病患者，该患者病情缓解和加重2次，并回顾了日本之前报道的患者。一名54岁女性因双侧上肢震颤、精神症状、意识障碍和抽搐等多种症状入住我院。类固醇脉冲疗法及随后的口服维持疗法使病情缓解。未出现复发。患者抗甲状腺抗体呈阳性。脑电图显示弥漫性慢波。对类固醇的反应提示为桥本脑病。根据以往研究，类固醇反应性脑病、非疱疹性边缘叶脑炎和桥本脑病在临床症状、磁共振成像（MRI）表现及对类固醇的反应方面相似。桥本脑病患者的抗甲状腺抗体水平通常会升高。然而，在这些疾病患者中测量该参数的情况很少见。对于特发性脑病/脑炎患者，应检测抗甲状腺抗体水平以促进准确诊断。
