L'encefalopatia di hashimoto nella diagnosi differenziale degli stati confusionali di tipo epilettico

We describe two patients with an encephalopathy associated with Hashimoto disease and a high title of antithyroid antibodies. They presented with subacute confusion, impairment of consciousness, seizures, tremolousness and stroke-like episodes. Symptoms typically appeared when patients were euthyroid. The EEG patterns varied over the course of the illness, and showed generalized slowing, frontal or temporal rhytmical theta or delta activity, often with epileptiform features. The long term prognosis is favorable with steroid therapy, though additional immunosuppressives may be required. Since clinical features of Hashimoto Encephalopathy are non-specific, infective, metabolic, toxic, vascular, neoplastic and paraneoplastic etiologies have to be excluded.