Functional neuroimaging in Hashimoto’s encephalitis: a physiopathological imaging?

  • Jordi Fuertes
  • Amparo García-Burillo
  • Joan Castell-Conesa
  • Isabel Roca
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Hashimoto’s encephalitis, a probably misdiagnosed disease, is also known as steroid-responsive encephalopathy associated with autoimmune thyroiditis [1]. We present a 79-year-old female with rapidly progressive dementia, serum values for hypothyroidism and clinical suspicion of the disease. She underwent a 99mTc-ECD brain perfusion single photon emission computed tomography (SPECT) scan, which showed global and severe hypoperfusion of the whole brain cortex (upper row). Anatomical neuroimaging (CT, MRI) was near-normal, showing only mild age-related cortical atrophy. After 8 months of corticoid therapy, the patient experienced a progressive clinical recovery of superior functions, and a control SPECT scan showed normal brain perfusion (lower row). The hypoperfusion pattern found in this patient might have been related to a vasculitic mechanism as has been reported in this kind of encephalopathy [2, 3]. Open image in new window

References

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    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(2):197–202.PubMedCrossRefGoogle Scholar
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    Mocellin R, Walterfang M, Velakoulis D. Hashimoto’s encephalopathy: epidemiology, pathogenesis and management. CNS Drugs 2007;21(10):799–811.PubMedCrossRefGoogle Scholar
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    Tamagno G, Federspil G, Murialdo G. Clinical and diagnostic aspects of encephalopathy associated with autoimmune thyroid disease (or Hashimoto’s encephalopathy). Intern Emerg Med 2006;1(1):15–23.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Jordi Fuertes
    • 1
  • Amparo García-Burillo
    • 1
  • Joan Castell-Conesa
    • 1
  • Isabel Roca
    • 1
  1. 1.Department of Nuclear MedicineGamma DelfosBarcelonaSpain

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