Affiliations: Department of Clinical Neurophysiology, University
Hospital of Poitiers, Poitiers, France | Department of Immunology, University Hospital of
Poitiers, Poitiers, France | Department of Neurology and Neuropsychology,
University Hospital of Poitiers, Poitiers, France | Department of Pediatrics, University Hospital of
Poitiers, Poitiers, France
Note: [] Correspondence: Dr. Stéphane Besnard, Department of Clinical
Neurophysiology, University Hospital of Poitiers, 2, rue de la Milétrie,
86021 Poitiers Cedex, France. Tel.: +33 5 49 44 43 87; Fax: +33 5 49 44 43 01;
E-mail: [email protected]
Abstract: This case report presents a 14-month follow-up of a case of
Hashimoto's encephalopathy (HE) treated with immunoglobulins for the first time
in an 11-year-old adolescent. The diagnostic criteria were: (a) a drop in
school performance and psychological withdrawal for several weeks, (b) an
euthyroid state with a past medical history of autoimmune thyroiditis treated
with thyroxin, (c) a first episode of tonic-clonic seizure with clinical and
electroencephalographic (EEG) findings of encephalopathy, (d) a high serum
concentration of antithyroglobulin and antithyroid peroxidase antibodies, (e)
negative results of cerebrospinal fluid and blood studies for viral and
bacterial infections. Her acute epileptic symptoms resolved with clonazepam.
Immunoglobulin therapy (400 mg/kg/day for 5 days every 6 weeks) was given for
14 months. Her cognitive function was greatly improved but a light-to-mild
cognitive deficit remained. An EEG performed at her 14-month follow-up showed a
correlation with her cognitive improvement. We suggest that immunoglobulin can
be used as a first-line therapy in HE to avoid side effects or relapses as has
been described with long-term steroid therapy.
