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目的分析桥本脑病的临床特点,以期提高对本病的诊治效果。方法回顾性分析本院收治的5例桥本脑病患者临床资料,包括临床表现、实验室及影像学检查特点及治疗。结果 5例患者中3例表现意识障碍,其中2例伴有癫痫发作;1例表现进行性加重的智能减退,同时伴精神症状;1例表现Parkinson样锥体外系症状及视力减退。5例患者中血清抗甲状腺抗体水平均明显增高,脑电图均有异常,头部MRI改变缺乏特异性。5例经糖皮质激素治疗后4例临床症状明显改善,1例症状部分改善。结论桥本脑病是一种伴有抗甲状腺抗体水平增高、临床表现多样且缺乏特异性的脑病,对激素治疗反应良好。
Objective To analyze the clinical features of Hashimoto’s encephalopathy in order to improve the diagnosis and treatment of this disease. Methods The clinical data of 5 patients with Hashimoto ’s encephalopathy treated in our hospital were analyzed retrospectively, including clinical manifestations, characteristics of laboratory and imaging examination and treatment. Results Three of the five patients showed disturbance of consciousness, two of them had seizures, one showed progressive deterioration of mental retardation accompanied by psychiatric symptoms, and one showed Parkinson-like extrapyramidal symptoms and vision loss. Serum anti-thyroid antibody levels were significantly elevated in 5 patients, with abnormal EEG and lack of specific MRI changes in the head. After treatment with glucocorticoid in 5 cases, the clinical symptoms of 4 cases were significantly improved, and one case showed some improvement. Conclusion Hashimoto’s encephalopathy is a kind of encephalopathy associated with an increased level of anti-thyroid antibodies, diverse clinical manifestations and lack of specificity, and good response to hormone therapy.