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

M. M. Mancardi, F. Fazzini, A. Rossi, Roberto Gaggero

Research output: Contribution to journalArticle

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 neuropsychiatrie 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.

Original languageEnglish
Pages (from-to)218-220
Number of pages3
JournalNeuropediatrics
Volume36
Issue number3
DOIs
Publication statusPublished - Jun 2005

Keywords

  • Autoimmune disease
  • Hashimoto's encephalopathy
  • Hashimoto's thyroiditis
  • Nucleus accumbens
  • Ventral striatopallidal system

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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