Palatal-Myoclonus as a Presentation of Hashimoto Encephalopathy: an interesting case report

  • Esmaeel Ghoreishi Mail Department of Neurology, Ardebil University of Medical Sciences, Ardebil, Iran
  • Gholam Ali Shahidi Department of Neurology, Iran University of Medical Sciences, Tehran, Iran
  • Mohammad Rohani Department of Neurology, Iran University of Medical Sciences, Tehran, Iran
  • Mohammad Nabavi Department of Allergy and Immunology, Iran University of Medical Sciences, Tehran, Iran
  • Mahbubeh Aghaei Iran University of Medical Sciences, Tehran, Iran
  • Fahimeh Haji Akhoundi Iran University of Medical Sciences, Tehran, Iran
Keywords:
Hashimoto encephalopathy, abnormal movement, palatal myoclonus

Abstract

Objective: Hashimoto encephalopathy (HE) is known as a steroid-responsive encephalopathy associated with autoimmune thyroiditis or nonvascular inflammation-related autoimmune meningoencephalitis. The average age of onset of HE is approximately 50 years; and it is more common in women. The onset of HE may be acute or subacute. The course of most HE cases is relapsing and remitting, which is similar to that of vasculitis and stroke.
Methods: In this article, we present a previously healthy 32 years old; veterinarian male with palatal myoclonus, as a rare presentation of this disorder, and review the neurologic aspects of hashimoto encephalitis .
Results: The clinical presentation of HE is characterized by progressive cognitive decline tremor, transient aphasia, seizures, abnormal gait, sleep disorder and stroke-like episodes . Myoclonus, either generalized or multifocal, and tremor, often of the bilateral upper extremities, is the most frequently observed involuntary movements in HE.
Conclusion: The rapidly progressive cognitive dysfunction and encephalopathies observed.

References

Chong JY, Rowland LP, Utiger RD. Hashimoto encephalopathy: syndrome or myth? Arch Neurol 2003; 60:164-71.

Marshall GA, Doyle JJ. Long-term treatment of Hashimoto's encephalopathy. J Neuropsychiatry Clin Neurosci 2006; 18: 14-20.

Castillo P, Woodruff B, Caselli R, Vernino S, Lucchinetti C, Swanson J, et al. Steroid-Responsive Encephalopathy Associated with Autoimmune Thyroiditis. Arch Neurol 2006; 63: 197-202.

Ferracci F, Carnevale A. The neurological disorder associated with thyroid autoimmunity. J Neurol 2006; 253: 975-84.

Peschen-Rosin R, Schabet M and Dichgans J. Manifestation of Hashimoto's Encephalopathy Years before Onset of Thyroid Disease. Eur Neurol 1999; 41: 79-84.

Katoh N, Yoshida T, Shimojima Y, Gono T, Matsuda M, Yoneda M, et al. An 85-year-old case with Hashimoto's encephalopathy, showing spontaneous complete remission. Intern 2007; 46: 1613-6.

Brain L, Jellinek EH and Ball K. Hashimoto's Disease and Encephalopathy. Lancet 1966; 2: 512-514.

Erickson JC, Carrasco H, Grimes JB, Jabbari B, Cannard KR. Palatal tremor and myorhythmia in Hashimoto's encephalopathy. Neurology 2002; 58: 504-505.

Ryan SA, Kennedy C, Harrington HJ. Steroid-Responsive Encephalopathy Associated with Autoimmune Thyroiditis Presenting as Confusion, Dysphasia, and Myoclonus. Case reports in medicine 2012; 2012: 782127.

Zimmermann P, Stranzinger E. Steroid-Responsive Encephalopathy Associated with Hashimoto Thyroiditis. Pediatr Radiol 2012; 42: 891-893.

How to Cite
1.
Ghoreishi E, Shahidi GA, Rohani M, Nabavi M, Aghaei M, Akhoundi FH. Palatal-Myoclonus as a Presentation of Hashimoto Encephalopathy: an interesting case report. Iran J Psychiatry. 8(3):149-51.
QRcode
Section
Articles