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

  • Jordi Fuertes
  • Amparo García-Burillo
  • Joan Castell-Conesa
  • Isabel Roca
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Keywords

Public Health Nuclear Medicine Encephalitis Functional Neuroimaging 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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

  1. 1.
    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
  2. 2.
    Mocellin R, Walterfang M, Velakoulis D. Hashimoto’s encephalopathy: epidemiology, pathogenesis and management. CNS Drugs 2007;21(10):799–811.PubMedCrossRefGoogle Scholar
  3. 3.
    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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