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Hashimoto's Encephalopathy: A Brief Introduction


Updated June 03, 2014

Man with headache rubbing forehead
Paul Bradbury/OJO Images/Getty Images
by Mary Shomon

Hashimoto's Thyroiditis is the autoimmune thyroid disease that is the most common cause of hypothyroidism, an underactive thyroid. A very rare condition associated with Hashimoto's Thyroiditis is Hashimoto's Encephalopathy, a neuroendocrine disorder. Much like the antibodies in Hashimoto's Thyroiditis attack the thyroid, in Hashimoto's Encephalopathy, antibodies attack neurons in the brain. While Hashimoto's Encephalopathy is quite rare (there may only be several dozen diagnosed patients in the U.S.) it is also likely that there are many more undiagnosed sufferers. Because it is little known and its symptoms are primarily neurological, it is easy to misdiagnosis or overlook and the symptoms frequently lead to mistaken neurological diagnoses.

Some of the most common symptoms of Hashimoto's Encephalopathy include: disorientation, psychosis, tremors, concentration and memory problems, jerks in the muscles and lack of coordination, headaches, partial paralysis on the right side, and speech problems. Sometimes, patients are mistakenly diagnosed as having had a stroke, or having Alzeimer's. Typically, Hashimoto's antibodies levels will be high, and the patient may also have a diagnosable case of Hashimoto's Thyroiditis, but TSH levels may also be normal.

The condition can also appear in adolescents, but is even more likely to be overlooked. The symptoms in adolescents, unlike adults, frequently include seizures, confusion and hallucinations. A drop in school performance is also a common symptom, along with progressive cognitive decline. Thyroid autoantibody levels should be evaluated in these adolescents with these symptoms, even when thyroid function tests are normal. (Distinct Pediatric Manifestations of Hashimoto's Encephalopathy Described)

The primary treatment for Hashimoto's Encephalopathy is oral corticosteroid drugs - for example, Prednisone. While Hashimoto's Encephalopathy is a relapsing condition, the use of oral corticosteroids can keep the condition manageable for many patients.

Beverly Seminara, an international Hashimoto's Encephalopathy patient advocate, has researched the subject extensively on her own behalf, and has put her information together to share with other patients and practitioners. She has written the internet's only detailed patient-oriented overview of Hashimoto's Encephalopathy, located at: Hashimoto's Encephalopathy: A Neuroendocrine Disorder. Seminara has created a singular resource for patients and practitioners: Hashimoto's Encephalopathy - A Complete List of Published Case Studies.

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