ABSTRACT
OBJECTIVE: To present a case of Hashimoto encephalopathy as a complication of autoimmune thyroiditis. CLINICAL PRESENTATION AND INTERVENTION: A previously healthy 56-year-old female presented with rapidly progressive cognitive decline and visual hallucinations. Being a diagnosis of exclusion, Hashimoto encephalopathy required an extensive laboratory and diagnostic workup, which was done over the course of a 15-day hospitalization. The patient recovered after initial treatment with intravenous methylprednisolone and was then switched to prednisone p.o. CONCLUSION: This case report illustrates the importance of awareness for Hashimoto encephalopathy, as it remains one of the few easily treatable and reversible causes of rapid cognitive decline.
Subject(s)
Encephalitis/complications , Hashimoto Disease/complications , Thyroiditis, Autoimmune/complications , Anti-Inflammatory Agents/therapeutic use , Encephalitis/diagnosis , Encephalitis/drug therapy , Female , Hashimoto Disease/diagnosis , Hashimoto Disease/drug therapy , Humans , Methylprednisolone/therapeutic use , Middle Aged , Treatment OutcomeABSTRACT
Although most neurosurgeries are considered "sterile" procedures, anti-biotic prophylaxis is favored in the literature because of the potential for serious complications related to the central nervous system. There is a paucity of literature addressing the management of infectious complications related to neurostimulators and intraspinal/epidural catheters and pump; therefore, further studies are needed to develop standard protocols of care. Finally, perioperative complications in the patient undergoing a neuro-surgical procedure are similar to those undergoing any surgery, but have a higher potential for morbidity and mortality because of the central nervous system. The skill of the surgeon, care of the perioperative team, and knowledge of the neurologist remain the most important factors in the prevention, early recognition, and intervention of these complications.
