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Movement disorders in non-encephalopathic Hashimoto's thyroiditis

2018; Elsevier BV; Volume: 55; Linguagem: Inglês

10.1016/j.parkreldis.2018.06.008

1873-5126

Marcelo Miranda, M. Leonor Bustamante, Mario Campero, E Wainstein, Paola Toche, Alberto J. Espay, Ruth H. Walker, Anthony E. Lang,

Ion channel regulation and function

Since the seminal report of Lord Brain et al., in 1966 [ [1] Brain L. Jellinek E.H. Ball K. Hashimoto's disease and encephalopathy. Lancet. 1966; 2: 512-514 Abstract PubMed Google Scholar ], neurologic manifestations of Hashimoto's thyroiditis (HT) have been increasingly recognized, and it is now evident that clinical features are diverse and that the response to steroids is variable [ 2 Ferracci F. Moretto G. Candeago R.M. Cimini N. Conte F. Gentile M. Papa N. Carnevale A. Antithyroid antibodies in the CSF: their role in the pathogenesis of Hashimoto's encephalopathy. Neurology. 2003; 60: 712-714 Crossref PubMed Scopus (163) Google Scholar , 3 Selim M. Drachman D.A. Ataxia associated with Hashimoto's disease: progressive non-familial adult onset cerebellar degeneration with autoimmune thyroiditis. J. Neurol. Neurosurg. Psychiatry. 2001; 71: 81-87 Crossref PubMed Scopus (91) Google Scholar , 4 Rozankovic P.B. Rozankovic M. Susak I. Vlahovic I. Sporis D. Steroid-responsive autoimmune encephalopathy associated with autoimmune thyroiditis (SREAT) presenting with myoclonus-dystonia syndrome. J. Neurol. Sci. 2015; 354: 110-111 Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar , 5 Mocellin R. Walterfang M. Velakoulis D. Hashimoto's encephalopathy: epidemiology, pathogenesis and management. CNS Drugs. 2007; 21: 799-811 Crossref PubMed Scopus (171) Google Scholar ]. The term "steroid-responsive encephalopathy associated with autoimmune thyroiditis" (SREAT) has been proposed, however, signs of encephalopathy with altered mental state may be absent, as may clinical response to steroids. With respect to movement disorders, these are reported most often in the setting of encephalopathy; myoclonus is the commonest manifestation but dystonia, ataxia, tremor, and rarely chorea, are also described [ 3 Selim M. Drachman D.A. Ataxia associated with Hashimoto's disease: progressive non-familial adult onset cerebellar degeneration with autoimmune thyroiditis. J. Neurol. Neurosurg. Psychiatry. 2001; 71: 81-87 Crossref PubMed Scopus (91) Google Scholar , 4 Rozankovic P.B. Rozankovic M. Susak I. Vlahovic I. Sporis D. Steroid-responsive autoimmune encephalopathy associated with autoimmune thyroiditis (SREAT) presenting with myoclonus-dystonia syndrome. J. Neurol. Sci. 2015; 354: 110-111 Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar , 5 Mocellin R. Walterfang M. Velakoulis D. Hashimoto's encephalopathy: epidemiology, pathogenesis and management. CNS Drugs. 2007; 21: 799-811 Crossref PubMed Scopus (171) Google Scholar ]. We present two patients with HT with movement disorders without encephalopathy, thus we prefer to use the term "non-encephalopathic Hashimoto's thyroiditis" in this report.