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Autoimmune limbic encephalitis due to Hashimoto’s encephalopathy responding to therapeutic plasma exchange: A case report
Author(s) -
Ohnmar Ohnmar,
Win Sai Kyaw,
Tun Zin Phyu,
Aye Yin Minn,
Lwin Thandar,
Lay Phyu Phyu
Publication year - 2021
Publication title -
neurology and clinical neuroscience
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
0ISSN - 2049-4173
DOI - 10.1111/ncn3.12533
Subject(s) - medicine , limbic encephalitis , status epilepticus , encephalopathy , therapeutic plasma exchange , autoimmune encephalitis , pleocytosis , lymphocytic pleocytosis , encephalitis , cerebrospinal fluid , pathology , immunology , epilepsy , psychiatry , virus
A 66 years‐old lady presented with acute onset confusion and status epilepticus. MRI (Brain) showed T2 shine through at bilateral hippocampi. Cerebrospinal fluid revealed mild lymphocytic pleocytosis. Screening for infections, autoimmune and paraneoplastic conditions were negative except significantly high anti‐TPO antibody and hyperthyroid state. Her seizures needed multiple antiepileptic drugs. Limbic encephalitis was treated with high‐dose steroid but not responded and plasma exchange was proceeded. At two weeks after plasma exchange, her conscious level and seizure frequency were significantly improved. We present a case of Hashimoto's encephalopathy presenting with limbic encephalitis not responding to steroid but to plasma exchange.