桥本脑病伴帕金森综合征1例并文献复习

目的加深临床对桥本脑病的认识,提高临床诊出率。方法分析1例临床诊断为桥本脑病患者的临床表现、神经系统体征、实验室检查、电生理、影像学资料及治疗效果。结果患者神经系统表现为认知功能下降、帕金森综合征和癫痫发作,脑脊液IgG合成率增高,头MRI颅内多发病灶,脑电图示慢波增多。糖皮质激素治疗有效。结论桥本脑病临床表现多样,还可伴随帕金森综合征,临床上对脑病患者应想到此病的可能性,避免误诊、漏诊。

Hashimoto encephalopathy with parkinsonism:a case report and review of literature

Objective To improve the recognition and diagnosis of Hashimoto encephalopathy.Methods One case of Hashimoto encephalopathy was analyzed for clinical manifestation,abnormal neurological signs,laboratory assays,electroencephalography test,imaging study and treatment.Results The patient showed cognitive impairment,parkinsonism and epilepsy.The CSF IgG synthesis rate is increased.There were multiple lesions in her brain MR imaging.The electroencephalography test showed generalized slowing.Corticosteroid therapy significantly improve her symptoms.Conclusion Hashimoto encephalopathy could present as parkinsonism,this treatable syndrome should be considered in patients with encephalopathy.