An Anti-NH2 Terminal of α-enolase Antibody-positive Hashimoto's Encephalopathy with Bilateral Basal Ganglia Lesions: A Case Report and Literature Review

Abstract

Hashimoto's encephalopathy (HE) is a type of encephalopathy characterized by neuropsychiatric symptoms, high serum anti-thyroid antibody concentrations, and good responsiveness to immunotherapy. We herein report a rare case of HE with positive serum anti-NH2 terminal of α-enolase (NAE) antibodies and abnormal findings in the bilateral basal ganglia on brain magnetic resonance imaging (MRI). In cases presenting with isolated lesions in the basal ganglia, HE should not be excluded from the differential diagnosis, particularly when other causes are excluded and serum anti-thyroid antibodies are elevated. In such cases, testing for anti-NAE antibodies may aid in the diagnosis.