hashimoto s encephalitis
Download
Skip this Video
Download Presentation
Hashimoto’s Encephalitis

Loading in 2 Seconds...

play fullscreen
1 / 10

Hashimoto’s Encephalitis - PowerPoint PPT Presentation


  • 627 Views
  • Uploaded on

Hashimoto’s Encephalitis. Jamie Parrott, MD Carolinas Medical Center Dept. of Neurology. Hashimoto’s Thyroiditis. Chronic autoimmune thyroiditis seen in 8% of females, 3% of males, 10% of females over 55y Hashimoto’s (chronic lymphocytic) thyroiditis is the most common form

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' Hashimoto’s Encephalitis' - bowen


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
hashimoto s encephalitis

Hashimoto’s Encephalitis

Jamie Parrott, MD

Carolinas Medical Center

Dept. of Neurology

hashimoto s thyroiditis
Hashimoto’s Thyroiditis
  • Chronic autoimmune thyroiditis seen in 8% of females, 3% of males, 10% of females over 55y
  • Hashimoto’s (chronic lymphocytic) thyroiditis is the most common form
  • Most common cause of sporatic goiter in children (1.2% prevalence)
hashimoto s thyroiditis1
Hashimoto’s Thyroiditis
  • Exponential increase in last 40 years
  • T-cell mediated
  • Usually asymptomatic
  • Present with hypothyroidism (20%), goiter, or both
  • 5% incidence of hypothyroidism per year following diagnosis
  • 95% Female, usually between ages 30-50y
hashimoto s thyroiditis2
Hashimoto’s Thyroiditis
  • Thyroid antibodies targeted
    • Thyroglobulin
    • Thyroid microsomal antigen (thyroid peroxidase)
    • TSH receptor
  • Association with type I DM, multiple sclerosis, rheumatoid arthritis, Turner syndrome, celiac disease, vitaligo
hashimoto s encephalitis1
Hashimoto’s Encephalitis
  • Rare condition associated with HT
  • 2 to 3 per 100,000 prevalence
  • Triad of encephalopathy, high serum antithyroid antibodies, and responsiveness to steroids
  • Majority euthyroid
  • 82% female
  • All pediatric case reports female, 9-18y
hashimoto s encephalitis2
Hashimoto’s Encephalitis
  • Two distinct patterns
    • Acute type characterized by seizures, stroke-like episodes with transient neurologic deficits, altered mental status. Recurrent.
    • Subacute with insidious onset over weeks. Confusion, agitation, restless, hallucinations, dementia in the absence of focal neurologic deficits
    • No relationship with presence of hypothyroidism and severity of symptoms
hashimoto s encephalitis3
Hashimoto’s Encephalitis
  • Possible underlying mechanisms
    • CNS autoimmune vasculitis (lymphocytic perivascular infiltrate seen pathologically in 2 of 9 patients, Odie et al)
    • Formation of antineural antibodies (Archambeaud et al; alpha enolase ab, Ochi et al; antithyroid antibody titers in CSF not related to severity of disease)
hashimoto s encephalitis4
Hashimoto’s Encephalitis
  • Severity of symptoms unrelated to antibody titers, thyroid function
  • Reported symptoms: seizures, myoclonus, Stiff-limb syndrome, stroke-like symptoms, cerebellar dysfunction, psychosis, confusion, depression, headache, hypothermia, coma
hashimoto s encephalitis5
Hashimoto’s Encephalitis
  • CSF protein elevated 75%
  • CSF pleocytosis 25%
  • EEG changes nonspecific (slowing)
  • MRI typically normal (occasional T2-weighted abnormalities)
hashimoto s encephalitis6
Hashimoto’s Encephalitis
  • Rapid response to steroids
  • Full recovery 3-4 weeks
  • Acute form is frequently recurrent, consider prophylaxis
ad