Amnesic syndrome with bilateral mesial temporal lobe involvement in Hashimoto's encephalopathy |
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Authors: | McCabe D J Burke T Connolly S Hutchinson M |
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Affiliation: | Department of Neurology, St. Vincent's Hospital, Elm Park, Dublin, Ireland. d.mccabe@ion.ucl.ac.uk |
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Abstract: | A 25-year-old woman presented with a subacute confusional state, headaches, unsteadiness, myoclonus, seizures, and an amnesic syndrome as a manifestation of Hashimoto's encephalopathy. Investigations showed biochemical hypothyroidism, raised thyroid microsomal antibodies, and weakly positive antineuronal antibodies. A T2-weighted MRI of the brain showed bilateral symmetric areas of increased signal in the mesial temporal lobes and hippocampi that had a low signal intensity on T1-weighted imaging. Despite clinical and radiologic improvement after steroid and thyroid hormone replacement therapy, a severe amnesic syndrome with associated localized MRI abnormalities persists. |
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