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Academia Mexicana de Neurología, A.C.

2014, Number 3

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Rev Mex Neuroci 2014; 15 (3)

Response to steroids and electroconvulsive therapy in Hashimoto’s encephalopathy: Case report and literature review

Rodríguez-Ramírez S, Trejo-Terreros V, Téllez-Martínez JA, Rivera-Moscoso R, Mendoza-Velásquez JJ

Language: Spanish
References: 30
Page: 171-174
PDF size: 87.15 Kb.


ABSTRACT

Introducción: Hashimoto’s encephalopathy (HE)is an uncommon clinical entity with a broad clinical presentation and it is often underdiagnosed. It is characterized by the presence of cognitive impairment, neurologic and psychiatric symptoms in the absence of viral, bacterial or inflammatory causes in patients with autoimmune thyroiditis.
Case Report: A-38-year old female presented with psychiatric symptoms and hyperthyroidism, for which she received antithyroid treatment and then radioiodine ablation with no improvement of psychiatric symptomatology. Studies revealed high levels of antithyroid antibodies and infectious, vascular and neoplastic etiologies were ruled out. Bearing in mind the possibility of HE, steroids were administered for two weeks without success, and then, electroconvulsive therapy was administered with marked improvement of symptoms after the first session. We present a narrative review with systematic search on the subject.
Conclusion: Electroconvulsive therapy may be a useful alternative, coupled with the use of steroids, in patients with refractory HE. Lack of knowledge of the disease leads to delayed diagnosis, leading to delays in treatment, and thus, a poor prognosis.


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