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Hashimoto's encephalopathy, also known as steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), is a neurological condition characterized by encephalopathy, thyroid autoimmunity, and good clinical response to corticosteroids.
In areas where iodine-deficiency is not found, the most common type of hypothyroidism is an autoimmune subtype called Hashimoto's thyroiditis, with a prevalence of 1-2%. [40] As for hyperthyroidism, Graves' disease, another autoimmune condition, is the most common type with a prevalence of 0.5% in males and 3% in females. [41]
Hashimoto's thyroiditis, also known as chronic lymphocytic thyroiditis, Hashimoto's disease, and autoimmune thyroiditis is an autoimmune disease in which the thyroid gland is gradually destroyed. [7] [1] Early on, symptoms may not be noticed. [3] Over time, the thyroid may enlarge, forming a painless goiter. [3]
Most frequent are symptoms due to conjunctival or corneal irritation: burning, photophobia, tearing, pain, and a gritty or sandy sensation. [4] Protruding eyeballs (known as proptosis and exophthalmos). Diplopia (double vision) is common. [4] Limitation of eye movement (due to impairment of eye muscle function).
Signs and symptoms of hyperthyroidism may include irritability, muscle weakness, sleeping problems, a fast heartbeat, poor tolerance of heat, diarrhea and unintentional weight loss. [1] Other symptoms may include thickening of the skin on the shins, known as pretibial myxedema , and eye bulging , a condition caused by Graves' ophthalmopathy . [ 1 ]
People with hypothyroidism often have no or only mild symptoms. Numerous symptoms and signs are associated with hypothyroidism and can be related to the underlying cause, or a direct effect of having not enough thyroid hormones. [14] [15] Hashimoto's thyroiditis may present with the mass effect of a goitre (enlarged thyroid gland). [14]
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Depending on the type and severity of encephalopathy, common neurological symptoms are loss of cognitive function, subtle personality changes, and an inability to concentrate. Other neurological signs may include dysarthria , hypomimia , problems with movements (they can be clumsy or slow), ataxia , tremor . [ 6 ]