与自身免疫性甲状腺炎相关的类固醇反应性脑病（SREAT）伴单纯小脑共济失调
Steroid-responsive Encephalopathy Associated with Autoimmune Thyroiditis (SREAT) Presenting with Pure Cerebellar Ataxia.
作者信息
Termsarasab Pichet, Pitakpatapee Yuvadee, Frucht Steven J, Srivanitchapoom Prachaya
机构信息
Neurology Division, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Movement Disorder Division, Department of Neurology, New York University Langone Health, New York, NY, USA.
出版信息
Tremor Other Hyperkinet Mov (N Y). 2018 Aug 9;8:585. doi: 10.7916/D8CZ4QQQ. eCollection 2018.
BACKGROUND
Myoclonus and tremor are common movement disorder phenomenologies in steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT). Pure ataxia without encephalopathy has rarely been reported.
CASE REPORT
We report 21- and 40-year-old females who presented with subacute pure ataxia without encephalopathy. After immunotherapies, both exhibited initial improvement of ataxia, and subsequently remained in plateau phase.
DISCUSSION
This treatable disorder should be added to the differential diagnoses of progressive cerebellar ataxia, and anti-thyroid peroxidase and anti-thyroglobulin should be considered as part of the workup. It is crucial not to misdiagnose SREAT presenting with pure cerebellar ataxia as degenerative or spinocerebellar ataxia.
背景
肌阵挛和震颤是自身免疫性甲状腺炎相关类固醇反应性脑病（SREAT）中常见的运动障碍表现。很少有关于无脑病的单纯性共济失调的报道。
病例报告
我们报告了两名分别为21岁和40岁的女性，她们表现为无脑病的亚急性单纯性共济失调。免疫治疗后，两人的共济失调均有初步改善，随后进入平台期。
讨论
这种可治疗的疾病应纳入进行性小脑共济失调的鉴别诊断中，抗甲状腺过氧化物酶和抗甲状腺球蛋白应作为检查的一部分。至关重要的是，不要将表现为单纯性小脑共济失调的SREAT误诊为退行性或脊髓小脑共济失调。
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