Hashimoto encephalopathy with positive oligoclonal bands in cerebrospinal fluid

Abstract

Introduction: Hashimoto encephalopathy (HE) is a rare and often misdiagnosed entity. Except high levels of the thyroid peroxidase (anti-TPO) and antithyroglobulin (anti-TG) antibodies, neurophysiological and psychological tests are beneficial for the diagnosis. The presence of oligoclonal bands in the cerebrospinal fluid (CSF) of these patients is very rare. We present a patient with HE and oligoclonal bands in CSF with good clinical response on corticosteroid therapy. Case report: Male patient, 39 years old, suddenly developed focal neurologic deficit. He had elevated anti-TPO and anti TG antibodies, impaired concentration on psychologist report and oligoclonal bands in CSF. Slowing of electroencephalography activity was normalized with full clinical recovery of the patients, after corticosteroid therapy. The patient is in clinical remission 5 years after establishing the diagnosis. Conclusion: Oligoclonal bands in the CSF may be helpful in the diagnosis of HE considering that it is still poorly understood entity. Also fast diagnosis of HE and treatment with corticosteroids are important for a full recovery of this patients.