Abstract

Hashimoto's encephalopathy (HE) is a rare, clinically heterogeneous condition associated with positive thyroid autoantibodies. It is increasingly recognized as an important and treatable cause of autoimmune encephalopathy. Thyroid-associated antibodies such as thyroperoxidase (TPO) antibody, thyroglobulin (TG) antibody, and thyrotropin receptor (TR) antibody were found in HE patients with seizure disorders. Although antithyroid antibodies are required for the diagnosis of HE, their role in the pathogenesis of HE remains uncertain. Instead of playing a key role in the pathophysiology processes of HE, it is suggested that thyroid-associated antibodies are hallmarks of HE. Seizure disorders were found in approximately two-thirds of HE patients, and common anticonvulsant therapy alone is usually ineffective. Some patients did not respond to any antiepileptic drugs. The use of immunotherapy can effectively control seizure disorders. Electroencephalography and imaging findings are not specific to HE patients and can also be seen in other causes of encephalopathies. However, the prognosis in the majority of patients with HE was usually good if it is diagnosed and treated correctly.

Highlights

  • Hashimoto’s encephalopathy (HE) is a rare clinical condition first described by Lord Brain [1]

  • We review the characteristics of seizure disorders and the diagnostics of HE

  • The diagnosis of HE still mainly depends on clinical presentation and supplementary examinations

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Summary

Introduction

Hashimoto’s encephalopathy (HE) is a rare clinical condition first described by Lord Brain [1]. Hashimoto’s Encephalopathy and Seizures Disorders patients have been reported in the literature, the specific mechanism of HE is not fully understood. It is suggested that HE is better termed autoimmune encephalopathy associated with thyroid antibodies because antithyroid antibodies are essential laboratory features of the diagnosis of HE [8].

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