Ishihara Kenji, Naitoh Yurino, Fukui Yasuhito, Asahi Toshiomi
Department of Neurology, Asahi Hospital of Neurology and Rehabilitation.
Department of Rehabilitation, Asahi Hospital of Neurology and Rehabilitation.
Rinsho Shinkeigaku. 2019 Sep 25;59(9):570-574. doi: 10.5692/clinicalneurol.cn-001301. Epub 2019 Aug 30.
Here, we describe a case involving an 83-year-old woman who was admitted to our hospital for rehabilitation after pseudogout treatment. She had temporal and spatial disorientation. Neuropsychological assessment revealed frontal dysfunction, memory impairment, and executive dysfunction, in addition to general cognitive impairment. Subsequent laboratory examination revealed euthyroid status and elevated titers of anti-thyroid autoantibodies. MRI of the brain revealed no abnormal finding. However, electroencephalography revealed diffuse slowness. We diagnosed Hashimoto's encephalopathy on the basis of the clinical symptoms and laboratory findings. Administration of low-dose prednisolone (5 mg/day) alleviated general cognitive impairment and the laboratory findings; however, memory impairment and construction disorder remained. Previous studies suggest that the characteristics and clinical course of higher brain-function disorder associated with Hashimoto's encephalopathy vary on an individual basis, wherein some patients may respond well to low-dose steroid therapy. Here, we also encountered such a case, that showed good response to a low-dose steroid therapy.
在此，我们描述了一例涉及一名83岁女性的病例，该女性在接受假痛风治疗后因康复入住我院。她存在时间和空间定向障碍。神经心理学评估显示除了一般认知障碍外，还存在额叶功能障碍、记忆障碍和执行功能障碍。随后的实验室检查显示甲状腺功能正常，但抗甲状腺自身抗体滴度升高。脑部MRI未发现异常。然而，脑电图显示弥漫性减慢。我们根据临床症状和实验室检查结果诊断为桥本脑病。给予低剂量泼尼松龙（5毫克/天）可缓解一般认知障碍和实验室检查结果；然而，记忆障碍和构图障碍仍然存在。先前的研究表明，与桥本脑病相关的高级脑功能障碍的特征和临床过程因人而异，其中一些患者可能对低剂量类固醇治疗反应良好。在此，我们也遇到了这样一个对低剂量类固醇治疗反应良好的病例。
