Hashimoto’s encephalopathy presenting periodic synchronous discharge, as a differential diagnosis for Creutzfeldt-Jakob disease

• Muramatsu Tomoko

  Second Department of Internal Medicine, Division of Neurology, Faculty of Medical Sciences, University of Fukui

• Hamano Tadanori

  Second Department of Internal Medicine, Division of Neurology, Faculty of Medical Sciences, University of Fukui

• Shirafuji Norimichi

  Second Department of Internal Medicine, Division of Neurology, Faculty of Medical Sciences, University of Fukui

• Matsunaga Akiko

  Second Department of Internal Medicine, Division of Neurology, Faculty of Medical Sciences, University of Fukui

• Ikawa Masamichi

  Second Department of Internal Medicine, Division of Neurology, Faculty of Medical Sciences, University of Fukui

• Yoneda Makoto

  Second Department of Internal Medicine, Division of Neurology, Faculty of Medical Sciences, University of Fukui

Bibliographic Information

Other Title

• Periodic synchronous dischargeを呈しCreutzfeldt-Jakob病との鑑別を要した橋本脳症の1例
• Periodic synchronous discharge オ テイシ Creutzfeldt-Jakobビョウ ト ノ カンベツ オ ヨウシタ ハシモト ノウショウ ノ 1レイ

Abstract

Here, we report a case of Hashimoto’s encephalopathy (HE) mimicking Creutzfeldt-Jakob disease (CJD). A 57-year-old man was admitted to our hospital for status epilepticus. He had gradually presented personality change over the last two years. On admission, he was in state of akinetic mutism. He exhibited seizures on the left side of his body, including the face, and intermittent myoclonic movement. Routine laboratory tests showed no abnormalities, including thyroid functions. An EEG study showed typical periodic synchronous discharge (PSD). Brain MRI showed high-intensity areas in the bilateral frontal cortex, thalamus, and right insula on diffusion-weighted imaging (DWI). So, initially, sporadic CJD was suspected. However, there were no abnormalities in the caudate or putamen on MRI. Anti-TG and anti-TPO antibodies, as well as anti-NAE antibody were all positive. He was administered methylpredonisolone pulse therapy. Subsequently, his consciousness levels and EEG and MRI findings markedly improved. So, he was finally diagnosed with HE. HE should be considerd in patients with PSD on EEG, even if the patients have typical MRI abnormalities of CJD. Anti-thyroid antibodies should be examined in such patients.

Journal

• Rinsho Shinkeigaku

  Rinsho Shinkeigaku 53 (9), 716-720, 2013

  Societas Neurologica Japonica

Keywords

• Hashimoto’s encephalopathy
• periodic synchronous discharge
• Creutzfeldt-Jakob disease
• anti-NAE antibody
• steroid therapy

Details

• CRID: 1390282680013293568
• NII Article ID: 40019800507
• NII Article ID: 130004505551
• NII Book ID: AN00253207
• DOI: 10.5692/clinicalneurol.53.716
• COI: 1:STN:280:DC%2BC2c%2FmtFCgtw%3D%3D
• ISSN: 18820654
• ISSN: 0009918X
• NDL BIB ID: 024872297
• PubMed: 24097320
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I024872297
• Web Site: https://search.jamas.or.jp/link/ui/2014046628
• Text Lang: ja
• Data Source:
  • JaLC
  • NDL
  • Crossref
  • PubMed
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed