Abstract
Objective Hashimoto thyroiditis (HT) is an autoimmune thyroid disease, characterized by different clinical courses and presentation. The purpose of this study was to identify the neurological manifestations of Hashimoto thyroiditis in children and evaluate their clinical outcome. Methods Fifteen patients under monitoring with a diagnosis of HT and also presenting with neurological manifestations were enrolled in the study. Patients presenting with change of consciousness was considered as Hashimoto's encephalopathy. Clinical outcomes were assessed by most recent neurological examinations during their visit at our pediatric neurology department. Results The study patients consisted of 2 boys and 13 girls. The mean age at diagnosis of patients was 12.8±2.83 years (age range, 6–17 years). The mean duration of follow-up was 25.8±12.7 months, and ranged from 6–48 months. At the time of presentation; 5 patients were euthyroid, and 10 was hypothyroid. Neurological findings at presentation included: headache in 10 patients, epileptic seizures in 5 patients, focal paresis in 4 patients, speech abnormalities in 3 patients, decreased school performance in 2 patients, ataxia in 2 patients, Hashimoto's encephalopathy in 2 patients, diplopia in 1 patients, status epilepticus in 1 patients, and coma in 1 patients. Abnormal electroencephalographic recordings revealed in 8 patients. All hypothyroid patients received thyroxine replacement therapy. Two patients received intravenous methylprednisolone, and 1 patient took intravenous immunoglobulin treatment. Four children received antiepileptic therapy for control of epileptic seizures. Four children improved spontaneously without any treatment. In contrast, Hashimoto's encephalopathy relapsed 6 times despite all the treatments in 1 patient during follow up period. Conclusion Hashimoto thyroiditis should be considered in any patient presenting with unexplained neuropsychiatric signs and symptoms.
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