Sapkota Sarita K, Sapkota Biggya L, Pitiyanuvath Nataria
Department of Medicine, UT college of Medicine Chattanooga, Chattanooga, TN, USA.
Southeast Regional Stroke Center at Erlanger Medical Center, Chattanooga, TN, USA.
Neurohospitalist. 2015 Apr;5(2):70-3. doi: 10.1177/1941874414554299.
Hashimoto encephalopathy (HE) is a rare autoimmune disease characterized by symptoms of acute or subacute encephalopathy associated with increased antithyroid antibody levels. Neurosarcoidosis is also a rare entity that occurs in less than 5% of patients with systemic sarcoidosis. Neurosarcoidosis usually presents with cranial neuropathies, myelopathy, or new-onset seizure. We report a case of a 49-year-old caucasian woman, previously healthy, who initially presented for a workup of a new-onset seizure. She had a gradually progressive course with neurocognitive decline and recurrent partial seizures refractory to conventional antiepileptic drugs. Her seizures responded well to a course of intravenous immunoglobulin. She was subsequently diagnosed with HE and pulmonary sarcoidosis based on serological and pathological studies. She improved neurologically once the seizures were controlled. Hashimoto encephalopathy is a rare condition that is potentially treatable and presents with various neuropsychiatric manifestations. It is a diagnosis of exclusion that requires a strong clinical suspicion and is often underrecognized.
桥本脑病（HE）是一种罕见的自身免疫性疾病，其特征为急性或亚急性脑病症状，同时抗甲状腺抗体水平升高。神经结节病也是一种罕见病症，在系统性结节病患者中发生率低于5%。神经结节病通常表现为颅神经病变、脊髓病或新发癫痫。我们报告一例49岁的白种女性病例，该女性此前身体健康，最初因新发癫痫前来检查。她的病情呈逐渐进展过程，伴有神经认知功能减退，且常规抗癫痫药物难以控制反复出现的部分性癫痫发作。她的癫痫发作经静脉注射免疫球蛋白治疗后反应良好。随后，根据血清学和病理学研究，她被诊断为桥本脑病和肺结节病。癫痫发作得到控制后，她的神经功能有所改善。桥本脑病是一种罕见疾病，具有潜在可治性，可表现出各种神经精神症状。它是一种排除性诊断，需要高度临床怀疑，且常常未被充分认识。
