Hashimoto's encephalopathy cases: Chinese experience.
Hashimoto's encephalopathy cases: Chinese experience.
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DOI：
10.1186/1471-2377-12-60
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发表时间：
2012-07-24
期刊：
影响因子：
2.6
通讯作者：
Jia J
中科院分区：
文献类型：
--
作者：
Tang Y;Xing Y;Lin MT;Zhang J;Jia J
桥本脑病是一种知之甚少的综合征，由不同的神经系统症状和高水平的血清抗甲状腺抗体滴度组成，通常对类固醇有反应。需要更多的临床系列研究来确定临床、实验室和影像特征，以及结果，特别是在中国人群中。我们回顾分析了2005-2010年间在北京宣武医院连续收治的13例桥本脑病患者的临床、实验室和影像特点及转归。认知障碍(84.6%)和精神症状(38.5%)是最常见的症状。癫痫(30.8%)和肌阵挛(7.7%)比以前描述的要少。3例(23.1%)患者海马区或颞叶出现异常信号，被认为与记忆障碍或癫痫发作有关。MRI改变显示1例患者的分辨率与临床改善平行。在接受类固醇治疗的8名患者中，5名患者痊愈，1名患者改善，残留缺陷，2名患者复发或无效。在5名非类固醇治疗的患者中，3名患者在接受抗癫痫药物或一般神经营养治疗后得到稳定缓解，2名患者的病情持续恶化。大多数桥本脑病患者对类固醇的反应良好。一些患者在没有类固醇治疗的情况下有所改善。考虑到桥本脑病的可逆过程，我们建议在评估中枢神经系统疾病时，应始终将桥本脑病列入鉴别诊断。
Hashimoto’s encephalopathy is a poorly understood syndrome consisting of heterogeneous neurological symptoms and high serum antithyroid antibody titers, typically responding to steroids. More clinical series studies are required to characterize the clinical, laboratory and imaging features, and outcomes, especially in the Chinese population. We analyzed the clinical, laboratory, and imaging features and outcomes of thirteen consecutive patients with Hashimoto’s encephalopathy diagnosed in Xuan Wu Hospital, Beijing from 2005 to 2010 retrospectively. Cognitive impairment (84.6%) and psychiatric symptoms (38.5%) were the most frequent symptoms. Seizures (30.8%) and myoclonus (7.7%) were less common than previously described. Three (23.1%) patients showed abnormal signals in hippocampus or temporal lobe, which were believed related to their memory disorders or seizures. MRI changes showed resolution paralleling clinical improvement in one patient. Among eight patients who received steroid therapy, five patients recovered, one patient improved with residual deficits, and two patients relapsed or had no effect. Among five non-steroid treated patients, three patients experienced stable remission with antiepileptic drugs or general neurotrophic therapy, and two patients experienced continuous deterioration. Most patients with Hashimoto’s encephalopathy showed good response to steroids. Some patients improved without steroid therapy. Considering its reversible course, we recommend that Hashimoto’s encephalopathy should always be in the differential diagnosis while evaluating disorders of the central nervous system.
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