Aydin-Ozemir Zeynep, Tüzün Erdem, Baykan Betül, Akman-Demir Gülşen, Ozbey Neşe, Gürses Candan, Christadoss Premkumar, Gökyiğit Ayşen
Department of Neurology, Istanbul University, Istanbul, Turkey.
Clin EEG Neurosci. 2006 Jul;37(3):204-9. doi: 10.1177/155005940603700308.
We report the first case of an autoimmune thyroid encephalopathy presenting with multifocal motor status epilepticus. A 37-year-old female patient was admitted with multifocal motor seizures intractable to intravenous status epilepticus treatments, asymmetrical quadriparesis, truncal ataxia and continuous semi-rhythmical jerks. Pathological signal alterations were detected in both precentral cortices in MRI examination. Autoimmune thyroiditis was diagnosed after radiological examinations of the thyroid gland and thyroid function tests. Seizures promptly ceased following intravenous steroid treatment. Immunohistochemistry studies showed mild to moderate neuronal staining with the plasma and CSF samples. Remarkably, autoimmune thyroiditis may present with migrating focal motor status epilepticus. We recommend anti-thyroid antibody screening for multifocal motor status epilepticus cases of unspecified cause.
我们报告了首例以多灶性运动性癫痫持续状态为表现的自身免疫性甲状腺脑病病例。一名37岁女性患者因多灶性运动性癫痫发作入院，静脉注射抗癫痫药物治疗无效，伴有不对称性四肢瘫、躯干共济失调和持续的半节律性抽搐。MRI检查发现双侧中央前回皮质有病理信号改变。经甲状腺影像学检查和甲状腺功能测试后诊断为自身免疫性甲状腺炎。静脉注射类固醇治疗后癫痫发作迅速停止。免疫组化研究显示血浆和脑脊液样本中有轻度至中度神经元染色。值得注意的是，自身免疫性甲状腺炎可能表现为游走性局灶性运动性癫痫持续状态。对于病因不明的多灶性运动性癫痫持续状态病例，我们建议进行抗甲状腺抗体筛查。
