Pinedo-Torres Isabel, Paz-Ibarra José Luis
Departamento de Endocrinología, Hospital Nacional Daniel Alcides Carrión, Callao, Perú. Address: Avenida del pacífico 180, Torre 14, Departamento 704, Condominios Parques de la Huaca, San Miguel, Lima, Perú. Email:
Departamento de Endocrinología, Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima, Perú.
Medwave. 2018 Oct 22;18(6):e7298. doi: 10.5867/medwave.2018.06.7298.
Hashimoto's encephalopathy is a rare disease, with a reported prevalence of 2.1 per 100 000. Clinical manifestations include confusion, decreased state of consciousness, cognitive deficit, seizures, myoclonus, ataxia, and focal neurological deficits. Due to the wide variety of signs and symptoms, clinical diagnostic suspicion is essential. Diagnosis is based on three pillars: the presence of neurological clinical manifestations after ruling out other causes of encephalopathy. 2) Presence of increased antithyroid antibodies. 3) Significant clinical improvement after the administration of immunomodulation. The treatment of Hashimoto's encephalopathy pursues two objectives: to control the autoimmune process and to control the complications of the disease. Although in most cases recovery is complete with treatment, the risk of relapse can range from 12.5 to 40% in follow-ups to 2 years.
桥本脑病是一种罕见疾病，报告的患病率为每10万人中有2.1例。临床表现包括意识模糊、意识状态下降、认知缺陷、癫痫发作、肌阵挛、共济失调和局灶性神经功能缺损。由于体征和症状多种多样，临床诊断怀疑至关重要。诊断基于三个要点：1）在排除其他脑病病因后存在神经临床表现。2）抗甲状腺抗体升高。3）免疫调节治疗后临床显著改善。桥本脑病的治疗有两个目标：控制自身免疫过程和控制疾病并发症。虽然在大多数情况下治疗后可完全康复，但在长达2年的随访中，复发风险为12.5%至40%。
