Hashimoto’s encephalopathy presenting as Wernekinck commissure syndrome: A case report
- 1 May 2022
- journal article
- research article
- Published by Dustri-Verlgag Dr. Karl Feistle in Clinical Neuropathology
- Vol. 41 (05), 128-134
- https://doi.org/10.5414/np301399
Abstract
The Wernekinck commissure syndrome is extremely rare in a clinical setting. This condition has been previously reported in association with midbrain infarction, midbrain hemorrhage, demyelinating pseudotumor, and optic neuromyelitis spectrum disease, but not with Hashimoto???s encephalopathy. Herein, we report the case of a 44-year-old hypertensive man who developed cerebellar ataxia, internuclear ophthalmoplegia, and cognitive decline. Magnetic resonance imaging (MRI) of the brain revealed brain stem damage involving Wernekinck commissure. Initially, this patient was diagnosed with acute midbrain infarction in another hospital. However, his symptoms did not improve after the administration of anti-platelet aggregation drugs, statin, and free radicals scavenging treatment. Re-examination of cranial MRI revealed abnormal signals in the left parietal lobe. After a series of investigations that excluded cerebral infarction and encephalopathy was finally diagnosed. The patient???s symptoms improved remarkably after treatment with methylprednisolone and ??-globulin. To the best of our knowledge, there are no other reports on the onset of Wernekinck commissure syndrome in the clinical manifestations of Hashimoto???s encephalopathy.Keywords
This publication has 21 references indexed in Scilit:
- Hashimoto's encephalopathy: Report of three casesJournal of the Formosan Medical Association, 2014
- Cognitive and affective dysfunctions in autoimmune thyroiditisBrain, Behavior, and Immunity, 2014
- Hashimoto’s Encephalopathy: A Brief ReviewCurrent Neurology and Neuroscience Reports, 2014
- The Horseshoe-Shaped Commissure of Wernekinck or the Decussation of the Brachium Conjunctivum Methodological Changes in the 1840sThe Cerebellum, 2013
- Hashimoto’s encephalopathy cases: Chinese experienceBMC Neurology, 2012
- Wernekink commissure syndrome: a rare midbrain syndromeNeurological Sciences, 2012
- Central Nervous System Vasculitis With Positive Antithyroid Antibodies in an Adolescent BoyPediatric Neurology, 2011
- Hashimoto EncephalopathyThe Neurologist, 2009
- Hashimoto's EncephalopathyAnnals of the New York Academy of Sciences, 2008
- Hashimoto?s encephalopathy presenting with psychosis and generalized absence statusZeitschrift für Neurologie, 2004