Hashimoto's encephalopathy: a report of three cases and relevant literature reviews.

Hashimoto's encephalopathy (HE) is a very rate condition characterized by various clinical features consisting of psychiatric manifestations, seizures and focal neurologic deficits. In this study, three Hashimoto's encephalopathy cases were reported, including two female patients and one male patient. The two female patients (22-year-old and 49-year-old) were presented with brainstem involvement and the symptoms progressed gradually. The 70-year-old male patient was diagnosed with space-occupying lesion that seemed to be malignant, but the symptom was substantially ameliorated right after glucocorticoid therapy. Pathological studies indicate abnormal blood vessels are important in the progression of the disease. Compared with current reports, the male case was the first patient diagnosed of Hashimoto's encephalopathy but presented with malignant features and local occupying effect. Intracranial lesions were found in all of the three patients, but these lesions responded well to glucocorticoid therapy. And the lesions were remarkably reduced after treatment. Meanwhile, the prognosis of diffuse Hashimoto's encephalopathy is better than the vascular type.