Jessica’s Story of Autoimmune Brain Disease Part I
Jessica’s Story of Autoimmune Brain Disease Part II
Hashimoto’s Encephalopathy (HE) is a type of autoimmune encephalitis (AE) in which the body’s immune system attacks the brain, resulting in inflammation. HE is also known as Steroid Responsive Encephalopathy Associated with Thyroiditis (SREAT), Encephalopathy Associated with Autoimmune Thyroid Disease (EAATD), and Non-vasculitic Autoimmune Inflammatory Meningoencephalitis (NAIM).
HE is considered a rare disease and is very under diagnosed and misdiagnosed. The presenting symptoms can mimic other illnesses. The disease is generally reported to follow one of two patterns:
1. Relapse remitting- stroke-like episodes. Symptoms vary in intensity and duration and can come and go quickly
2. Progressive- It may be more frequently characterized by dementia and psychiatric symptoms.
Many patients, however, display an overlap in symptoms between the two types.
• Relapsing/remitting strokes
• Transient focal neurological deficits and associated sensory/motor difficulties
• Seizures (as well as status epilepticus)
• Myoclonus (muscle jerking) or tremor
• Change in cognition (confusion, alertness, orientation)
• Psychotic symptoms (hallucinations, delusional thought content)
If left untreated, autoimmune encephalopathies can result in coma and death.
The causes of HE are not yet known. HE diagnoses occur more frequently in women than men (2:1 ratio) and patients are most commonly in their 40s-50s. Most people with HE respond well to corticosteroid therapy or other immunosuppressive therapies and symptoms typically improve or resolve over a few months.
Patients with HE often have other autoimmune conditions, making it difficult to discern whether presenting symptoms have resulted from HE or another co-morbid condition.
People with HE also frequently have elevated thyroid antibodies. It is important to keep in mind that elevated antithyroid antibodies are present in both HE and another disease called Hashimoto’s thyroiditis (an autoimmune disease of the thyroid.) Both of these conditions have overlapping symptoms including fatigue and cognitive difficulties. However, they are nevertheless ENTIRELY separate conditions with their own distinct causes, treatments and prognosis.
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