DOI QR코드

DOI QR Code

Febrile Hashimoto's encephalopathy mimicking infectious encephalitis

  • Lee, Jung-Ju (Department of Neurology, Eulji Medical Center, Eulji University College of Medicine) ;
  • Youn, Michelle Sojung (Department of Neurology, Eulji Medical Center, Eulji University College of Medicine) ;
  • Park, Jong-Moo (Department of Neurology, Eulji Medical Center, Eulji University College of Medicine) ;
  • Kwon, Ohyun (Department of Neurology, Eulji Medical Center, Eulji University College of Medicine) ;
  • Lee, Woong-Woo (Department of Neurology, Eulji Medical Center, Eulji University College of Medicine) ;
  • Kang, Kyusik (Department of Neurology, Eulji Medical Center, Eulji University College of Medicine) ;
  • Kim, Byung Kun (Department of Neurology, Eulji Medical Center, Eulji University College of Medicine)
  • 투고 : 2019.08.20
  • 심사 : 2019.11.13
  • 발행 : 2020.04.30

초록

Hashimoto's encephalopathy (HE) is a heterogeneous encephalopathy with diverse clinical presentations. Here we report on a 69-year-old woman who presented with confusion, aphasia, fever, and focal ictal discharges. Cerebrospinal fluid analysis and a workup for other fever origins revealed no abnormality and a high level of thyroperoxidase antibody was detected, which findings led to a diagnosis of HE. The symptoms subsided after treatment. This study highlights the importance of considering HE in patients presenting with fever and abnormal EEG findings.

키워드

참고문헌

  1. Brain L, Jellinek E, Ball K. Hashimoto's disease and encephalopathy. Lancet 1966;2:512-514. https://doi.org/10.1016/S0140-6736(66)92876-5
  2. Chong JY, Rowland LP, Utiger RD. Hashimoto encephalopathy: syndrome or myth? Arch Neurol 2003;60:164-171. https://doi.org/10.1001/archneur.60.2.164
  3. Henchey R, Cibula J, Helveston W, Malone J, Gilmore RL. Electroencephalographic findings in Hashimoto's encephalopathy. Neurology 1995;45:977-981. https://doi.org/10.1212/WNL.45.5.977
  4. Papathanasopoulos P, Mallioris K, Karanasios P, Dimopoulos D, Papapetropoulos T. Febrile Hashimoto's encephalopathy. J Neurol Neurosurg Psychiatry 2000;68:795. https://doi.org/10.1136/jnnp.68.6.795
  5. Kayser L, Broholm H, Francis D, Perrild H, Olsen BE, Bendtzen K, et al. Immunocytochemical localisation of tumour necrosis factor alpha in thyroid tissues from patients with neoplastic or autoimmune thyroid disorders. Autoimmunity 1996;23:91-97. https://doi.org/10.3109/08916939608995332
  6. Semel JD. Complex partial status epilepticus presenting as fever of unknown origin. Arch Intern Med 1987;147:1571-1572. https://doi.org/10.1001/archinte.1987.00370090051010
  7. el-Ad B, Neufeld MY. Periodic febrile confusion as a presentation of complex partial status epilepticus. Acta Neurol Scand 1990;82:350-352. https://doi.org/10.1111/j.1600-0404.1990.tb03315.x
  8. Matsuda N, Akanuma J, Shimizu S, Shibano K, Nakahara T, Sugiyama Y, et al. Recurrent episodes of fever of unknown origin as temporal lobe epilepsy. Rinsho Shinkeigaku 2000;40:999-1002.
  9. Leitinger M, Beniczky S, Rohracher A, Gardella E, Kalss G, Qerama E, et al. Salzburg Consensus Criteria for Non-Convulsive Status Epilepticus-approach to clinical application. Epilepsy Behav 2015;49:158-163. https://doi.org/10.1016/j.yebeh.2015.05.007
  10. Ch'ien LT, Boehm RM, Robinson H, Liu C, Frenkel LD. Characteristic early electro-encephalographic changes in herpes simplex encephalitis. Arch Neurol 1977;34:361-364. https://doi.org/10.1001/archneur.1977.00500180055011