Hashimoto encephalopathy presenting as schizophrenia-like disorder
Journal
Cognitive and Behavioral Neurology
Journal Volume
22
Journal Issue
3
Pages
197-201
Date Issued
2009
Author(s)
Abstract
OBJECTIVE: Hashimoto encephalopathy (HE) is associated with numerous neuropsychiatric symptoms and responds well to steroid therapy. In the past, only a few cases were reported to present with pure psychiatric syndromes. We describe a case of HE with presenting symptoms like that of schizophrenic patients. METHODS: We describe a 73-year-old woman with a history of autoimmune thyroiditis. She had psychotic symptoms for 3 years that responded poorly to antipsychotic agents, and she was thus admitted in 2007. RESULTS: The diagnosis of HE was made, although the patient presented neurologic symptoms and signs including abnormal electroencephalography, recent memory impairment, and executive function declination. The psychotic symptoms subsided completely in a few days after high-dose intravenous steroid therapy. CONCLUSIONS: The neuropsychiatric manifestation of HE can be similar to typical schizophrenia. Considering the effectiveness of steroid therapy for HE, we suggested HE as an important differential diagnosis for psychotic disorders, particularly for those patients of late onset, with abnormal electroencephalography, history of autoimmune thyroiditis, or poor response to conventional psychiatric treatment, so as to provide prompt and effective treatment for these patients. Copyright ? 2009 by Lippincott Williams & Wilkins.
SDGs
Other Subjects
carbimazole; methylprednisolone; microsome antibody; neuroleptic agent; prednisolone; propylthiouracil; risperidone; steroid; thyroglobulin antibody; thyroid antibody; aged; antibody blood level; antibody titer; article; auditory hallucination; autoimmune thyroiditis; basal ganglion; brain infarction; brain tomography; case report; cognitive defect; computer assisted tomography; delusion; drug dose reduction; drug megadose; drug pulse therapy; drug substitution; drug withdrawal; EEG abnormality; electroencephalography; female; Hashimoto encephalopathy; hospital admission; human; insomnia; lacunar infarction; memory disorder; mental health; mesencephalon; neurologic examination; nuclear magnetic resonance imaging; paranoia; pons; priority journal; psychosis; schizophrenia; short term memory; steroid therapy; symptomatology; treatment outcome; very late onset schizophrenia like psychosis; Aged; Brain Diseases; Diagnosis, Differential; Electroencephalography; Female; Hashimoto Disease; Humans; Methylprednisolone; Schizophrenia; Treatment Outcome
Type
journal article