E5431. Hashimoto’s Encephalopathy: A Rare Neurologic Manifestation of Autoimmune Thyroiditis
Authors
Angela Kanna;
Tufts Medical Center
Neel Madan;
Brigham and Women's Hospital/_Massachusetts General Hospital
Background
Hashimoto’s encephalopathy is a diagnosis of exclusion that is rarely seen in patients with high levels of antithyroid antibodies. Presenting neurological symptoms are widely varied, and patients may not have clinical thyroid disease. Imaging studies are often negative or nonspecific.
Educational Goals / Teaching Points
Clinical presentation. Differential diagnosis. Review of imaging findings that have been observed in case reports. One case from our institution of Hashimoto’s encephalopathy. Second case from our institution with similar presentation and imaging findings in which Hashimoto’s was ruled out in favor of a more likely diagnosis.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Contrast-enhanced MRI of the brain is the most helpful imaging modality, although findings are often nonspecific or absent. Extensive work up and clinical correlation with laboratory values including CSF studies, patient history, and physical examination are required to make the diagnosis.
Conclusion
Hashimoto’s encephalopathy is a diagnosis of exclusion that is rarely seen in patients with high levels of antithyroid antibodies. If there are imaging findings suggestive of Hashimoto’s encephalopathy, the radiologist, in discussion with the clinical team, can recommend next steps to rule out other potential etiologies including infectious, noninfectious or inflammatory, and other autoimmune encephalitis.
