Reader response: Hashimoto encephalopathy in the 21st century.

Abstract

I read the interesting study on correlation of thyroid antibodies and neurologic manifestations specially the encephalopathy, psychosis, refractory seizures, etc.1 The simultaneous editorial on the same issue is also enlightening.2 The authors concluded that Hashimoto encephalopathy requires redefinition. Here, we would like to share our small but important experience. We found in a cohort of approximately 73 patients of noncompressive myelopathy and neuromyelitis optica spectrum disorder (NMOSD) and antibodies to thyroid peroxidase (TPOAb) positivity in 2 patients.3 The other antibodies relevant to NMOSD or myelitis and etiologic workup was noncontributory; hence, we connected it to the thyroid immune disorder or TPOAb. These patients had recurrent myelitis and required disease-modifying therapies besides steroids, and we concluded that this entity may be an independent marker of recurrence of the disease—i.e., myelitis. Similar to those patients implicated in earlier studies,4 they require disease-modifying therapy besides steroids because steroids alone are not sufficient.