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Recurrent status epilepticus associated with Hashimoto's encephalopathy.

Visée H, Mabiglia C, Vanderaspoilden V, Gazagnes MD, Glibert G - Epilepsy Behav Case Rep (2013)

Bottom Line: This evolution was especially marked by the occurrence of steroid-refractory symptoms and a poor outcome with persistent cognitive and behavioral consequences.This patient highlights the risk of multiple relapses and the need for a long follow-up period.We describe her clinical and paraclinical features, compare this patient to similar case reports, and comment on her outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Brugmann University Hospital, Brussels, Belgium.

ABSTRACT
Hashimoto's encephalopathy (HE) is an infrequent disease with no well-known physiopathology. Status epilepticus is rarely reported in association with HE. We describe the 7-year evolution of a young woman who presented with recurrent status epilepticus as the main complication of HE. This evolution was especially marked by the occurrence of steroid-refractory symptoms and a poor outcome with persistent cognitive and behavioral consequences. We point out that the frontal lobes are especially implicated in these symptoms. This patient highlights the risk of multiple relapses and the need for a long follow-up period. We describe her clinical and paraclinical features, compare this patient to similar case reports, and comment on her outcome.

No MeSH data available.


Related in: MedlinePlus

Line graph showing no correlation between antithyroglobulin (anti-TG) or anti-thyroperoxidase (anti-TPO) antibodies and events as status epilepticus (SE) or generalized convulsive seizure (GCS).
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f0015: Line graph showing no correlation between antithyroglobulin (anti-TG) or anti-thyroperoxidase (anti-TPO) antibodies and events as status epilepticus (SE) or generalized convulsive seizure (GCS).

Mentions: From a therapeutic point of view, her evolution was marked by successive steroid responsiveness, steroid dependence, prolonged remission after cyclophosphamide courses, late relapse of steroid-resistant symptoms, and thereafter persisting steroid dependence. No correlation could be made between the occurrence of steroid-resistant symptoms and a delay in the beginning of intravenous methylprednisolone. Steroid-resistant SE as a complication of HE seems to be infrequent (2/11, including our patient and one patient in Table 2) but does not exclude the diagnosis. As reported by other authors [5], a correlation has not been observed between relapses and the level of antithyroid-Ab (Fig. 3), sustaining the hypothesis that they do not play a part in the physiopathological development of HE.


Recurrent status epilepticus associated with Hashimoto's encephalopathy.

Visée H, Mabiglia C, Vanderaspoilden V, Gazagnes MD, Glibert G - Epilepsy Behav Case Rep (2013)

Line graph showing no correlation between antithyroglobulin (anti-TG) or anti-thyroperoxidase (anti-TPO) antibodies and events as status epilepticus (SE) or generalized convulsive seizure (GCS).
© Copyright Policy - CC BY-NC-SA
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150643&req=5

f0015: Line graph showing no correlation between antithyroglobulin (anti-TG) or anti-thyroperoxidase (anti-TPO) antibodies and events as status epilepticus (SE) or generalized convulsive seizure (GCS).
Mentions: From a therapeutic point of view, her evolution was marked by successive steroid responsiveness, steroid dependence, prolonged remission after cyclophosphamide courses, late relapse of steroid-resistant symptoms, and thereafter persisting steroid dependence. No correlation could be made between the occurrence of steroid-resistant symptoms and a delay in the beginning of intravenous methylprednisolone. Steroid-resistant SE as a complication of HE seems to be infrequent (2/11, including our patient and one patient in Table 2) but does not exclude the diagnosis. As reported by other authors [5], a correlation has not been observed between relapses and the level of antithyroid-Ab (Fig. 3), sustaining the hypothesis that they do not play a part in the physiopathological development of HE.

Bottom Line: This evolution was especially marked by the occurrence of steroid-refractory symptoms and a poor outcome with persistent cognitive and behavioral consequences.This patient highlights the risk of multiple relapses and the need for a long follow-up period.We describe her clinical and paraclinical features, compare this patient to similar case reports, and comment on her outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Brugmann University Hospital, Brussels, Belgium.

ABSTRACT
Hashimoto's encephalopathy (HE) is an infrequent disease with no well-known physiopathology. Status epilepticus is rarely reported in association with HE. We describe the 7-year evolution of a young woman who presented with recurrent status epilepticus as the main complication of HE. This evolution was especially marked by the occurrence of steroid-refractory symptoms and a poor outcome with persistent cognitive and behavioral consequences. We point out that the frontal lobes are especially implicated in these symptoms. This patient highlights the risk of multiple relapses and the need for a long follow-up period. We describe her clinical and paraclinical features, compare this patient to similar case reports, and comment on her outcome.

No MeSH data available.


Related in: MedlinePlus