The patient had a history of upper respiratory tract infection 2 days before the onset of these symptoms, which was characterized by nasal congestion and throat dryness, with no significant fever, cough, or expectoration. Furthermore, we retrieved 20 representative patients diagnosed as HE with cerebellar ataxia as the main symptom from PubMed and reviewed their etiology, clinical manifestations, auxiliary examination, diagnosis, prognosis, and treatment.Ī 64-year-old female with a complaint of dizziness and gait instability for 1 month was admitted to our hospital. In addition, we summarized its clinical features, diagnosis, and treatment in conjunction with the literature to enhance the understanding of HE in clinical practice, expecting to reduce the missed diagnosis rate of the disease.

Here we report a rare case of HE with acute cerebellar ataxia as the main manifestation, elevated anti-thyroid antibodies (anti-TPO/TG), and normal thyroid function. Meanwhile, there are no clear diagnostic criteria for HE, so it is easy to be ignored or misdiagnosed in clinical practice. To date, clinical reports of cerebellar ataxia as the main symptom of HE are rare. It is believed that HE is related to the autoimmune reaction secondary to Hashimoto's thyroiditis, and the immune inflammatory reaction during the pathogenic process may lead to focal or diffuse brain damage in the brain, leading to clinical symptoms such as unconsciousness or focal neurological loss including cognitive impairment, tremor, altered consciousness, transient aphasia, seizures, myoclonus, gait disorder/ataxia ( 2). Hashimoto's encephalopathy (HE) is an autoimmune encephalopathy related to thyroid antibodies, which was first reported by Brain et al. In conclusion, based on our case findings and literature review, the diagnosis of HE should be suspected in cases of encephalopathy without an obvious cause, to quickly start an effective treatment.

Meanwhile, we reviewed the clinical features of 20 representative cases of HE with cerebellar ataxia as the core symptoms. The symptoms of cerebellar ataxia improved after steroid treatment. We reported a case of Hashimoto's encephalopathy with cerebellar ataxia as the main manifestation, elevated anti-thyroid antibodies (anti-TPO/TG), and normal thyroid function. The hallmark presenting feature is a non-specific encephalopathy characterized by alteration of mental status and consciousness ranging from confusion to coma and impaired cognitive function, while those with cerebellar ataxia as the main manifestation is rare. Hashimoto's encephalopathy (HE), also known as steroid responsive encephalopathy associated with autoimmune thyroiditis (SREAT), has a variety of clinical manifestations, with various neuropsychiatric characteristics, including tremors, transient aphasia, seizures, altered consciousness, myoclonus, cognitive impairment, and psychiatric manifestations.

Hashimoto brain fog treatment