Hashimoto's encephalopathy with selective involvement of the nucleus accumbens: a case report.

Abstract:

:Hashimoto's encephalopathy (HE) is an acute or subacute relapsing disorder usually affecting euthyroid patients with evidence of autoimmune thyroiditis. The neurological manifestations are non-specific, with subacute cognitive impairment, movement disorders, generalized seizures, focal neurological symptoms such as stroke-like episodes, or psychiatric disturbances. Autoimmune phenomena are likely to play an etiological role. Magnetic resonance imaging (MRI) findings are usually normal or show non-specific changes. We report the case of an 11-year-old girl with autoimmune thyroiditis who presented acutely with a complex neuropsychiatric disorder in association with MRI evidence of focal involvement of the nucleus accumbens (NA). The NA, a ventral striate nucleus, is part of a complex dopaminergic network. Lesions to the NA result in several psychiatric symptoms, such as attention-deficit hyperactivity disorders. In this patient, we observed alternating phases of stupor and hyperkinetic-anxious behavior, with marked instability. The pathogenetic mechanism and the anatomic and functional correlations are briefly discussed.

journal_name

Neuropediatrics

journal_title

Neuropediatrics

authors

Mancardi MM,Fazzini F,Rossi A,Gaggero R

doi

10.1055/s-2005-865712

subject

Has Abstract

pub_date

2005-06-01 00:00:00

pages

218-20

issue

3

eissn

0174-304X

issn

1439-1899

journal_volume

36

pub_type

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