桥本脑病(文献综述及一例报道)  

Hashimoto's encephalopathy——case report and literature review

作　　者：周昭远[1] 程桦[2] 洪铭范[3] 黄凤[1] 苏全喜[3] 叶健华[1] 马承红[1] 朱平[2] 

机构地区：[1]广东药学院附属第一医院内分泌科,广州510080 [2]广州中山大学附属第二医院内分泌科 [3]广东药学院附属第一医院神经科,广州510080

出　　处：《中华内分泌代谢杂志》2007年第6期562-564,共3页Chinese Journal of Endocrinology and Metabolism

摘　　要：桥本脑病(又称自身免疫性甲状腺炎相关的糖皮质激素敏感性脑病)是与桥本甲状腺炎相关的以神经系统症状为主要表现的疾病,呈急性或亚急性起病,出现癫痫发作、震颤、肌阵挛、共济失调、精神病等表现,有复发及缓解交替过程。桥本脑病患者有高滴度的抗甲状腺抗体,甲状腺功能正常或异常,脑脊液蛋白质含量升高,脑电图呈弥漫性慢波,大部分影像学检查无异常,少数出现白质T2加权相弥漫性信号增强。目前发病机制还不清楚。现报道一例桥本脑病患者。建议在临床工作中如果遇到无法解释的脑病时,如果抗甲状腺抗体滴度高,即使甲状腺功能正常也要考虑桥本脑病的可能性。Hashimoto＇s eneephalopathy （steroid-responsive eneephalopathy associated with autoimmune thyroiditis, SREAT） is a rare disorder, accompanied by seizures, tremor, myoclonus, ataxia, psychosis, and stroke-like episodes, breaking out with an acute or subaeute onset and having a relapsing/remitting or progressive eourse which is not correlated to thyroid hormone levels, Patients with Hashimoto＇s eneephalopathy are usually euthyroid or dysthyroid with positive antithyroid antibodies, have a moderately raised eerebrospinal fluid protein content, and have a global slowing of the electroencephalogram and a normal or near normal imaging except in rare cases. The pathogenesis of Hashimoto＇s encephalopathy is still obscure, This paper reports a case diagnosed as ＂Hashimoto＇s encephalopathy＂. It is suggested that the diagnosis of Hashimoto＇s encephalopathy should be considered in cases with unexplained encephalopathy associated with high levels of antithyroid antibodies despite normal thyroid function.

关 键 词：桥本脑病 抗甲状腺抗体 甲状腺炎 自身免疫性 

分 类 号：R747.9[医药卫生—神经病学与精神病学]