Understanding Hashimoto's Encephalopathy 2016 Edition:
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The exact cause of HE/SREAT is as yet unknown.

We do know that in patients with HE/SREAT, “antithyroid antibodies … are the hallmark of this disease.”1 High serum (blood) antibody titers for thyroid peroxidase (TPO) or other anti-thyroid antibodies are found. The exact correlation or pathogen is not currently known.2

The current accepted theory is that HE/SREAT is an autoimmune condition. While further research is still pending, Japanese research has turned up the presence of antibodies to alpha-enolase (serum autoantibodies against the NH2-terminal of a-enolase3,4,5) in addition to the presense of other anti-thyroid antibodies in the serum. At this time, this research is limited.

While at this time there is no difinitive diagnostic criteria for HE/SREAT itself, in February of 2016 Dr. Josep Dalmau et. al published the first broadly accepted criteria for diagnosing autoimmune encephalitis in the publication, The Lancet. This important paper includes ground-breaking guidelines for the diagnosis of antibody negative autoimmune encephalopathies (of which HE/SREAT is believed to be one due to the indefinate presense of a unique antibody).

While it is not known at this time how widely this criteria will be used in diagnosing HE/SREAT in the United States, it is an important contribution to the diagnosis of autoimmune encephalitis and encephalopathies. The article is entitled, “A clinical approach to the diagnosis of autoimmune encephalitis“, and is available for purchase online via The Lancet.



1 “Hashimoto’s Encephalopathy: Case Report and Literature Review”
Charles F. Guardia and James L. Bernat
SOJ Neurol
2014 Vol.1, No.1, pg 2.

2 Hashimoto’s encephalopathy: A rare proteiform disorder
Montagna, et al.
Journal of Pediatric Endocrinology and Metabolism Year
Available online February 3rd 2016

3 “Hashimoto’s encephalopathy as a treatable adult-onset cerebellar ataxia mimicking spinocerebellar degeneration.”
Matsunaga, Akiko, Masamichi Ikawa, Akihiro Fujii, Yasunari Nakamoto, Masaru Kuriyama, and Makoto Yoneda.
European Neurology
201 Vol.69, No.1 pg 14-20

4 [Anti-NAE autoantibodies and clinical spectrum in Hashimoto’s encephalopathy].
Matsunaga, A., and M. Yoneda.
Rinsho byori. The Japanese journal of clinical pathology
2009 Vol.57, No.3, pg 271-278.

5 [Diagnosis and treatments of Hashimoto’s encephalopathy]. (In Japanese)
Yoneda M
Rinsho Shinkeigaku = Clinical Neurology
2012, Vol.52, No.11, pg 1240-1242

Last edited by Web Team on June 20th, 2016

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AE Alliance
"The Autoimmune Encephalitis Alliance promotes collaboration to improve care, find a cure and create community so that no one faces autoimmune encephalitis alone.

The Encephalitis Society
"The Encephalitis Society is an International organization providing information and support for all causes of Encephalitis."

Encephalitis Global
"Encephalitis Global is a U.S.A. 501(c)(3) non-profit organization formed in 2005 as an alliance connecting encephalitis survivors and caregivers around the world."

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Toll-free numbers from the National Library of Medicine's Health Hotlines Database.

HE Notebook - Wordpress Site
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