Sabbah-Talasazan Liorah, Piryatinsky Irene
a Department of Psychology , Suffolk University , Boston , Massachusetts , USA.
b Department of Psychiatry , Beth Israel Deaconess Medical Center , Boston , Massachusetts , USA.
Appl Neuropsychol Adult. 2018 Nov-Dec;25(6):572-580. doi: 10.1080/23279095.2017.1326048. Epub 2017 May 26.
Hashimoto's encephalopathy (HE) is a rare neurological syndrome characterized by the presence of positive serum antithyroid antibodies, altered mental status, and clinical response to glucocorticoid therapy. Although HE has been documented in the literature from a medical standpoint, reports on the neuropsychological presentation of this syndrome are scarce. This article presents a literature review of cognitive deficits reported in HE cases. In addition, we describe the case of a 76-year-old Russian speaking woman diagnosed with HE in May 2012. MRIs from her disease course and treatment are presented. Posttreatment neuropsychological testing revealed intact attention and construction and impairment in working memory, processing speed, learning, executive functioning, language, and bilateral fine motor dexterity, all of which impacted her functional abilities. Her profile was inconsistent with the typical dementia process. This case demonstrates the utility of neuropsychological assessment for understanding cognitive and functional consequences of HE. The issue of differential diagnosis with dementia is also discussed.
桥本脑病（HE）是一种罕见的神经综合征，其特征为血清抗甲状腺抗体阳性、精神状态改变以及对糖皮质激素治疗有临床反应。尽管从医学角度来看，文献中已有关于HE的记载，但关于该综合征神经心理学表现的报道却很稀少。本文对HE病例中报告的认知缺陷进行了文献综述。此外，我们描述了一例2012年5月被诊断为HE的76岁说俄语女性的病例。展示了她病程及治疗过程中的核磁共振成像（MRI）。治疗后的神经心理学测试显示，其注意力和结构能力正常，但工作记忆、处理速度、学习能力、执行功能、语言能力以及双侧精细运动灵活性受损，所有这些都影响了她的功能能力。她的情况与典型的痴呆过程不一致。该病例证明了神经心理学评估对于理解HE的认知和功能后果的实用性。同时也讨论了与痴呆症鉴别诊断的问题。
