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Table 1 Clinical findings and treatment outcomes of 13 patients with Hashimoto’s Encephalopathy

From: Hashimoto’s encephalopathy cases: Chinese experience

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
  1. Abbreviations: TPO, thyroid peroxidase; TG, thyroglobulin; MMSE, Mini-Mental State Examination; CMS, Clinical Memory Scale; WAIS-RC, Wechsler Adult Intelligence Scale-Revise Chinese; MRC, Medical Research Council.
  2. CSF protein: −, normal; +, elevated protein levels; MRI: −, normal; +, abnormal signals or cerebral atrophy; EEG: −, normal; +, generalized slowing; ++, epileptiform abnormalities.