Recurent Coma in Patient with Hashimoto’s Encephalites

Guliko Kiliptari

Recurent Coma in Patient with Hashimoto’s Encephalites

Keywords : Hashimoto encephalitis, TPO antibodies, Refractory and intractable seizures


Encephalitis is a severe inflammatory disorder of the brain with many possible causes and with difficult differentiate of diagnosis. One of the most important challenges is the elucidation of the causes of seizure disorders. Encephalopathy associated with autoimmune thyroid disease (EAAT) is a rare clinical entity, which presents with unspecific neurological symptoms. The clinical presentation is more frequently insidious, with cognitive and behavioural disturbance. Hashimoto's encephalopathy is rare disorder of presumed autoimmune origin characterized by cognitive decline, seizures, neuro-psychiatric symptoms, high titers of Anti-Thyroid-Peroxidase AB, and a positive response to steroids. There is no established correlation between the titer of TPO and severity of autoimmune encephalopathy, or its response to the therapy. Though the cortical and subcortical system may appear to be clinically involved in these cases, brain Magnetic Resonance Imaging (MRI) studies are usually unremarkable.
We presented one case of unexplained reasion of coma and refractory status epilepticus. The patient underwent CT, MRT, EEG examinations, spinal fluid examination on viruses and autoimmune antibodies, feces analysis on Hymenolepios, but rezult was negative. She was performed anticonvulsants therapy, but after short-term improvement patient was returning to the clinic with unexplained coma and convulsions.
We measured serum levels of thyroid autoantibodies and noticed it's elevated level, with statistical significant difference from normal values.


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