Hashimoto's Encephalopathy Presenting with Smoldering Limbic Encephalitis

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Author(s)

    • Nagano Masahiro
    • Department of Neurology, Kyoto University Graduate School of Medicine, Japan
    • Kobayashi Katsuya
    • Department of Neurology, Kyoto University Graduate School of Medicine, Japan
    • Kuzuya Akira
    • Department of Neurology, Kyoto University Graduate School of Medicine, Japan
    • Matsumoto Riki
    • Department of Neurology, Kyoto University Graduate School of Medicine, Japan
    • Oita Jiro
    • Department of Neurology, Shimizu Hospital, Japan
    • Yoneda Makoto
    • Faculty of Nursing and Social Welfare Sciences, Fukui Prefectural University, Japan
    • Ikeda Akio
    • Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, Japan
    • Takahashi Ryosuke
    • Department of Neurology, Kyoto University Graduate School of Medicine, Japan

Abstract

<p>Hashimoto's encephalopathy (HE) is a steroid-responsive autoimmune encephalopathy associated with Hashimoto thyroiditis. We herein report a case of HE manifesting "smoldering" limbic encephalitis with persisting symptoms and abnormalities on examinations. Although our patient experienced partial clinical remission after treatment, hippocampal hypermetabolism on [<sup>18</sup>F] fluorodeoxyglucose positron emission tomography (FDG-PET) and subclinical seizures on video electroencephalography persisted. Hypermetabolism on FDG-PET was improved by additional prednisolone therapy. Thus, as with other autoimmune limbic encephalitis cases, HE can take a course of "smoldering" encephalitis. FDG-PET and electroencephalogram findings can reflect the disease activity degree in such patients, although with certain neurophysiological and biochemical distinctions. </p>

Journal

  • Internal Medicine

    Internal Medicine 58(8), 1167-1172, 2019

    The Japanese Society of Internal Medicine

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