Table 1 Clinical findings and treatment outcomes of 13 patients with Hashimoto’s Encephalopathy
NO. | Sex | Age (year) | Duration | Clinical manifestations | Cognitive tests | Antibodies, U/ml (before treatment) | CSF protein | MRI | EEG | Treatment | Antibodies, U/ml (after treatment) | Follow-up period (month) | Clinical course |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | F | 52 | 19 months | Memory impairment, psychiatric symptoms, insomnia | MMSE, 21 | TPO>1300 | + | + | Levothyroxine | 22 | No improvement | ||
TG>500 | |||||||||||||
2 | F | 32 | 6 months | Generalized seizures | TPO>1300 | + | − | ++ | Antiepileptic treatment | 12 | No further seizures | ||
TG>500 | |||||||||||||
3 | M | 58 | 1 year | Recurrent stroke-like episodes, multiple cognitive domains impairment, psychiatric symptoms | MMSE, 20 | TPO 831.9 | + | − | ++ | Intravenous methylprednisolone 500 mg for 3 d followed by oral prednisone taper | TPO 492.0 | 13 | Two stroke-like episodes |
TG 41.9 | TG 40.7 | ||||||||||||
4 | M | 27 | 3 weeks | Memory impairment | MMSE, 25 | TPO>1300 | + | + | − | Nerve growth factor, vitamin B12 | 15 | Return to normal cognitive function, MMSE, 30 | |
TG 38.8 | |||||||||||||
5 | F | 29 | 6 years | Memory impairment, psychiatric symptoms, aphasia, seizures, myoclonus | CMS, 47 | TPO 519.1 | − | + | Intravenous methylprednisolone 1 g for 5 d | 20 | No improvement | ||
TG 114.7 | |||||||||||||
6 | F | 46 | 3 days | Stroke-like episode, multiple cognitive domains impairment, hypersomnolence, headache | TPO 557.8 | − | + | − | Intravenous methylprednisolone 1 g for 5 d followed by oral prednisone taper | TPO 273.8 | 22 | Complete remission, no further stroke-like episode | |
TG 44.3 | TG 40.2 | ||||||||||||
7 | M | 63 | 7 days | Acute headache, multiple cognitive domains impairment | MMSE, 17 | TPO>1300 | − | + | + | Intravenous methylprednisolone 1 g for 5 d | 17 | Complete remission, no headache, MMSE, 24 | |
TG 122.6 | |||||||||||||
8 | F | 43 | 2 months | Ataxia, memory impairment, seizures | MMSE, 19 | TPO >1300 | + | − | ++ | Intravenous methylprednisolone 1 g for 5 d | 13 | Complete remission, no further seizures, MMSE, 26 | |
TG 115.9 | |||||||||||||
9 | F | 21 | 2 months | Generalized seizures | TPO >1300 | + | + | ++ | Antiepileptic drugs | 9 | No further seizures | ||
TG 37.9 | |||||||||||||
10 | F | 40 | 1 month | Dizziness, memory impairment, psychiatric symptoms, hypersomnolence | CMS, 72 | TPO 139.6 | − | + | Intravenous methylprednisolone 500 mg for 5 d followed by oral prednisone tapering | 25 | Complete remission, no dizziness and hypersomnolence, CMS, 91 | ||
TG 24.2 | |||||||||||||
11 | F | 37 | 2 years | Memory impairment, tremor | CMS, 68 | TPO>1300 | − | − | − | Nerve growth factor, vitamin B12 | 20 | Continue progression | |
TG 104.9 | |||||||||||||
12 | F | 50 | 4 years | Multiple cognitive domains impairment, insomnia, psychiatric symptoms | MMSE, 9 | TPO >1300 | + | + | + | Intravenous dexamethasone, 10 mg for 2 weeks, followed by oral methylprednisolone taper | 19 | Partial improvement, MMSE, 16 | |
TG 46.9 | |||||||||||||
13 | F | 43 | 3 months | Stroke-like episode, lateralized sensory deficits, dizziness, memory impairment | WAIS-RC, 84 | TPO >1300 | + | + | + | Intravenous methylprednisolone 500 mg for 5 d followed by oral prednisone taper | TPO 1144.8 | 18 | Complete remission, no further stroke-like episode |
TG 45.6 | TG 48.4 |