{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T18:51:01Z","timestamp":1760986261658,"version":"3.37.3"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T00:00:00Z","timestamp":1718064000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T00:00:00Z","timestamp":1718064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004332","name":"Seoul National University Hospital","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004332","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Neurol Belg"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background and purpose<\/jats:title>\n                <jats:p>Diagnosing Hashimoto\u2019s encephalopathy (HE) is challenging. In contrast to other types of autoimmune encephalitis, HE shows an excellent response to steroid treatment. We aimed to investigate the rates of antithyroid antibodies (ATAs) and probable HE in patients with unexplained mental dysfunction and compare the clinical characteristics between the good- and poor-outcome groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We retrospectively reviewed the medical records and electroencephalography (EEG) and neuroimaging findings of patients admitted to the Department of Neurology of our hospital from March 1, 2006, to February 28, 2023. Using our proposed diagnostic criteria for probable HE, we compared the clinical characteristics between the good- and poor-outcome groups. We also investigated the rates of ATA positivity and probable HE.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In total, 198 patients exhibited altered mentation, rapidly progressive cognitive decline, or myoclonus. ATA tests were performed on 86 patients, and the detection rates of ATAs and probable HE were 29.1% and 25.6%, respectively. Of the 22 patients enrolled, the good- and poor-outcome groups comprised 19 and 3 patients, respectively. Clinical seizures occurred in seven patients. Nonconvulsive status epilepticus on EEG was observed in six patients, all of whom were intractable to antiepileptic drugs. Nineteen of 21 patients (90.5%) treated with immunosuppressants showed good outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>HE is a rare clinical disorder, but not as rare as previously thought. When HE is suspected, steroids should be considered the first-line treatment. Early diagnosis and adequate treatment are critical to achieve good outcomes in HE.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s13760-024-02520-1","type":"journal-article","created":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T12:12:20Z","timestamp":1718107940000},"page":"1839-1846","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical and diagnostic characteristics of Hashimoto\u2019s encephalopathy: a single-center, retrospective study"],"prefix":"10.1007","volume":"124","author":[{"given":"Jung-Ju","family":"Lee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soo-Min","family":"Park","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8064-6749","authenticated-orcid":false,"given":"Kyung-Il","family":"Park","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyusik","family":"Kang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Woong Woo","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Byung Kun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong Soo","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilhan","family":"Yoo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,6,11]]},"reference":[{"key":"2520_CR1","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/j.beem.2004.11.006","volume":"19","author":"V Fatourechi","year":"2005","unstructured":"Fatourechi V (2005) Hashimoto\u2019s encephalopathy: myth or reality? An endocrinologist\u2019s perspective. Best Pract Res Clin Endocrinol Metab 19:53\u201366","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"2520_CR2","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1196\/annals.1444.018","volume":"1142","author":"N Schiess","year":"2008","unstructured":"Schiess N, Pardo CA (2008) Hashimoto\u2019s encephalopathy. Ann N Y Acad Sci 1142:254\u2013265","journal-title":"Ann N Y Acad Sci"},{"key":"2520_CR3","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1001\/archneur.60.2.164","volume":"60","author":"JY Chong","year":"2003","unstructured":"Chong JY, Rowland LP, Utiger RD (2003) Hashimoto encephalopathy: syndrome or myth? Arch Neurol 60:164\u2013171","journal-title":"Arch Neurol"},{"key":"2520_CR4","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1097\/NRL.0b013e31813e34a5","volume":"13","author":"E T\u00fcz\u00fcn","year":"2007","unstructured":"T\u00fcz\u00fcn E, Dalmau J (2007) Limbic encephalitis and variants: classification, diagnosis and treatment. Neurologist 13:261\u2013271","journal-title":"Neurologist"},{"key":"2520_CR5","doi-asserted-by":"publisher","first-page":"1177","DOI":"10.1212\/01.WNL.0000122648.19196.02","volume":"62","author":"MJ Thieben","year":"2004","unstructured":"Thieben MJ, Lennon VA, Boeve BF, Aksamit AJ, Keegan M, Vernino S (2004) Potentially reversible autoimmune limbic encephalitis with neuronal potassium channel antibody. Neurology 62:1177\u20131182","journal-title":"Neurology"},{"key":"2520_CR6","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1016\/B978-0-12-802395-2.00020-1","volume":"145","author":"R H\u00f6ftberger","year":"2017","unstructured":"H\u00f6ftberger R, Lassmann H (2017) Immune-mediated disorders. Handb Clin Neurol 145:285\u2013299","journal-title":"Handb Clin Neurol"},{"key":"2520_CR7","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1016\/j.autrev.2016.09.008","volume":"15","author":"C Laurent","year":"2016","unstructured":"Laurent C, Capron J, Quillerou B, Thomas G, Alamowitch S, Fain O, Mekinian A (2016) Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT): characteristics, treatment and outcome in 251 cases from the literature. Autoimmun Rev 15:1129\u20131133","journal-title":"Autoimmun Rev"},{"key":"2520_CR8","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.790962","volume":"12","author":"J Yang","year":"2021","unstructured":"Yang J, Liu X (2021) Immunotherapy for refractory autoimmune encephalitis. Front Immunol 12:790962","journal-title":"Front Immunol"},{"key":"2520_CR9","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1016\/S0140-6736(66)92876-5","volume":"288","author":"L Brain","year":"1966","unstructured":"Brain L, Jellinek EH, Ball L (1966) Hashimoto\u2019s disease and encephalopathy. Lancet 288:512\u2013514","journal-title":"Lancet"},{"key":"2520_CR10","doi-asserted-by":"publisher","first-page":"799","DOI":"10.2165\/00023210-200721100-00002","volume":"21","author":"R Mocellin","year":"2007","unstructured":"Mocellin R, Walterfang M, Velakoulis D (2007) Hashimoto\u2019s encephalopathy: epidemiology, pathogenesis and management. CNS Drugs 21:799\u2013811","journal-title":"CNS Drugs"},{"key":"2520_CR11","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1016\/j.jbspin.2006.05.006","volume":"73","author":"A Bruns","year":"2006","unstructured":"Bruns A, Meyer O (2006) Neuropsychiatric manifestations of systemic lupus erythematosus. Joint Bone Spine 73:639\u2013645","journal-title":"Joint Bone Spine"},{"key":"2520_CR12","first-page":"251","volume":"24","author":"E Rosato","year":"2010","unstructured":"Rosato E, Pisarri S, Salsano F (2010) Current strategies for the treatment of autoimmune diseases. J Biol Regul Homeost Agents 24:251\u2013259","journal-title":"J Biol Regul Homeost Agents"},{"key":"2520_CR13","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1016\/j.je.2016.04.002","volume":"27","author":"Y Ono","year":"2017","unstructured":"Ono Y, Ono S, Yasunaga H, Matsui H, Fushimi K, Tanaka Y (2017) Clinical characteristics and outcomes of myxedema coma: analysis of a national inpatient database in Japan. J Epidemiol 27:117\u2013122","journal-title":"J Epidemiol"},{"key":"2520_CR14","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.1210\/js.2019-00076","volume":"3","author":"LA Burmeister","year":"2019","unstructured":"Burmeister LA (2019) Coma in thyroid storm: review of aggregated English-language case reports. J Endocr Soc 3:1261\u20131274","journal-title":"J Endocr Soc"},{"key":"2520_CR15","doi-asserted-by":"publisher","first-page":"e217","DOI":"10.1212\/WNL.0000000000008785","volume":"94","author":"S Mattozzi","year":"2020","unstructured":"Mattozzi S, Sabater L, Escudero D, Ari\u00f1o H, Armangue T, Simabukuro M et al (2020) Hashimoto encephalopathy in the 21st century. Neurology 94:e217\u2013e224","journal-title":"Neurology"},{"key":"2520_CR16","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1186\/1471-2377-12-60","volume":"12","author":"Y Tang","year":"2012","unstructured":"Tang Y, Xing Y, Lin MT, Zhang J, Jia J (2012) Hashimoto\u2019s encephalopathy cases: Chinese experience. BMC Neurol 12:60","journal-title":"BMC Neurol"},{"key":"2520_CR17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.seizure.2019.06.020","volume":"70","author":"T Ercoli","year":"2019","unstructured":"Ercoli T, Defazio G, Muroni A (2019) Status epilepticus in Hashimoto\u2019s encephalopathy. Seizure 70:1\u20135","journal-title":"Seizure"},{"key":"2520_CR18","doi-asserted-by":"publisher","first-page":"2125","DOI":"10.1016\/S1388-2457(00)00466-1","volume":"111","author":"ND Lawn","year":"2000","unstructured":"Lawn ND, Westmoreland BF, Sharbrough FW (2000) Multifocal periodic lateralized epileptiform discharges (PLEDs): EEG features and clinical correlations. Clin Neurophysiol 111:2125\u20132129","journal-title":"Clin Neurophysiol"},{"key":"2520_CR19","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1017\/S0317167100007332","volume":"34","author":"W Fitzpatrick","year":"2007","unstructured":"Fitzpatrick W, Lowry N (2007) PLEDs: clinical correlates. Can J Neurol Sci 34:443\u2013450","journal-title":"Can J Neurol Sci"},{"issue":"Suppl 3","key":"2520_CR20","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1046\/j.1528-1157.43.s.3.9.x","volume":"43","author":"RP Brenner","year":"2002","unstructured":"Brenner RP (2002) Is it status? Epilepsia 43(Suppl 3):103\u2013113","journal-title":"Epilepsia"},{"key":"2520_CR21","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1017\/S0317167100036040","volume":"13","author":"DE Eggertson","year":"1986","unstructured":"Eggertson DE, Pillay N (1986) Creutzfeldt-Jakob disease: correlation of focal electroencephalographic abnormalities and clinical signs. Can J Neurol Sci 13:120\u2013124","journal-title":"Can J Neurol Sci"},{"key":"2520_CR22","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1177\/155005941004100104","volume":"41","author":"O Fishman","year":"2010","unstructured":"Fishman O, Legatt AD (2010) PLEDs following control of seizures and at the end of life. Clin EEG Neurosci 41:11\u201314","journal-title":"Clin EEG Neurosci"},{"key":"2520_CR23","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.eplepsyres.2015.12.004","volume":"120","author":"F Rennebaum","year":"2016","unstructured":"Rennebaum F, Kassubek J, Pinkhardt E, H\u00fcbers A, Ludolph AC, Schocke M, Fauser S (2016) Status epilepticus: clinical characteristics and EEG patterns associated with and without MRI diffusion restriction in 69 patients. Epilepsy Res 120:55\u201364","journal-title":"Epilepsy Res"},{"key":"2520_CR24","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1016\/j.jocn.2016.09.019","volume":"35","author":"AC Gauthier","year":"2017","unstructured":"Gauthier AC, Baehring JM (2017) Hashimoto\u2019s encephalopathy mimicking Creutzfeldt-Jakob disease. J Clin Neurosci 35:72\u201373","journal-title":"J Clin Neurosci"},{"key":"2520_CR25","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1007\/s00415-004-0515-z","volume":"251","author":"T Vander","year":"2004","unstructured":"Vander T, Hallevy C, Alsaed I, Valdman S, Ifergane G, Wirguin I (2004) 14-3-3 protein in the CSF of a patient with Hashimoto\u2019s encephalopathy. J Neurol 251:1273\u20131274","journal-title":"J Neurol"},{"key":"2520_CR26","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.1136\/jnnp.74.7.1009","volume":"74","author":"W Paulus","year":"2003","unstructured":"Paulus W, Nolte KW (2003) Neuropathology of Hashimoto\u2019s encephalopathy. J Neurol Neurosurg Psychiatry 74:1009","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"2520_CR27","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1212\/WNL.54.3.769","volume":"54","author":"KW Nolte","year":"2000","unstructured":"Nolte KW, Unbehaun A, Sieker H, Kloss TM, Paulus W (2000) Hashimoto encephalopathy: a brainstem vasculitis? Neurology 54:769\u2013770","journal-title":"Neurology"},{"key":"2520_CR28","doi-asserted-by":"publisher","first-page":"30","DOI":"10.14791\/btrt.2017.5.1.30","volume":"5","author":"JS Lee","year":"2017","unstructured":"Lee JS, Jung TY, Lee KH, Kim SK (2017) Primary central nervous system vasculitis mimicking a cortical brain tumor: a case report. Brain Tumor Res Treat 5:30\u201333","journal-title":"Brain Tumor Res Treat"},{"key":"2520_CR29","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1007\/s00115-001-1261-4","volume":"73","author":"H Becker","year":"2002","unstructured":"Becker H, Hofmann M, von Einsiedel H, Conrad B, Sander D (2002) Circumscribed vasculitis with posterior infarct in Hashimoto encephalopathy. Nervenarzt 73:376\u2013379","journal-title":"Nervenarzt"}],"container-title":["Acta Neurologica Belgica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13760-024-02520-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s13760-024-02520-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13760-024-02520-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T02:05:44Z","timestamp":1733277944000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s13760-024-02520-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,11]]},"references-count":29,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["2520"],"URL":"https:\/\/doi.org\/10.1007\/s13760-024-02520-1","relation":{},"ISSN":["0300-9009","2240-2993"],"issn-type":[{"type":"print","value":"0300-9009"},{"type":"electronic","value":"2240-2993"}],"subject":[],"published":{"date-parts":[[2024,6,11]]},"assertion":[{"value":"22 November 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 February 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved by the Institutional Review Board of Nowon Eulji Medical Center, Eulji University (IRB No. 2023-05-013-002).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}