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KMID : 1201420180110010054
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Journal of Neurocritical Care
2018 Volume.11 No. 1 p.54 ~ p.57
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Hashimoto’s Encephalopathy with Reversible Diffuse Leukoencephal
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Hwang Woo-Sub
Jeong Da-Eun
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Abstract
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Background: The magnetic resonance imaging (MRI) findings of Hashimoto's encephalopathy (HE) are variable; images range from having a normal appearance, to showing ischemic lesions, demyelination, or vasogenic edema.
Case Report: A 57-year-old woman presented with a sudden onset of dysarthria and dizziness. Routine blood tests were normal and the MRI was unremarkable. After admission, she developed aphasic seizures and myoclonus, and eventually became comatose. A follow up MRI showed diffuse high signal intensities at the bilateral cerebral white matter on fluid attenuated inversion recovery imaging. The serum titers of the anti-thyroglobulin antibody and anti-thyroperoxidase antibody were increased. After 5 days of 1,000 mg/day of intravenous methylprednisolone infusion, she recovered rapidly.
Conclusions: We propose that repeated brain MRIs are necessary for the diagnosis of HE. Diffuse leukoencephalopathy may be a pathologic finding on MRI and, in this case study, was shown to be reversible after applying an appropriate treatment
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KEYWORD
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Hashimoto's disease, Leukoencephalopathies, Magnetic resonance imaging
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