Table 1
Movement disorders associated with anti-TPO/TG antibody-related neurologic disorders responsive to steroids.
| Author and year of publication | Age/Sex | Type of movement disorder | Thyroid status | Anti-thyroid antibody | Neuroimaging | Treatment | Outcome | |
|---|---|---|---|---|---|---|---|---|
| 1. | Mehta AB et al., [15] 1981 | 17/F | Torsion dystonia | Primary hyperthyroidism/thyrotoxicosis | Anti-TG+ Anti-TPO+ | No data available | Carbimazole and radioactive iodine | Euthyroid, dystonia was very mild with a slight tendency for torticollis and scoliosis to the right, and for the right outstretched arm to hyperpronate, provided drug compliant |
| 2. | Javaid A and Hilton DD [16] 1988 | 15/F | Generalized choreo-athetosis | Primary hyperthyroidism | Anti-TG+ Anti-TPO+ | No data available | Propranolol, carbimazole, tetrabenazine, chlorpromazine, and haloperidol | Refractory chorea. Chlorpromazine and tetrabenazine only partially suppressed it. At six months it was persisting. Haloperidol almost completely abolished chorea. It returned whenever she stopped taking haloperidol. Recurrence occurred 16 months after she first presented |
| 3. | Baba M et al., [17] 1992 | 23/F | Hemichorea | Primary hyperthyroidism/Graves’ disease | Anti-TG+ Anti-TPO- | No changes | Metoprolol, thiamazole and chlorpromazine | Improved |
| 4. | Hernández Echebarría LE et al., [18] 2000 | 41/F | Opsoclonus, myoclonus, and gait ataxia | Euthyroid→ subclinical hypothyroidism | Anti-TPO+ | SPECT showed decreased perfusion in the left fronto-parietal region and in the right basal ganglia | Antibiotics, acyclovir and valproate followed by L-thyroxin and steroids | At one-year follow-up, CSF analysis, SPECT, and electroencephalogram were normal. Anti-TPO decreased. She remained well at the last visit, two years after the onset of neurologic symptoms. |
| 5. | Taurin G et al., [19] 2002 | 77/F | Bilateral and axial choreic movements | Primary hypothyroidism | Anti-TG+ Anti-TPO+ | Cortico-subcortical atrophy | L-thyroxin and oral prednisolone | With 60 mg/day of prednisolone, chorea disappeared and reappeared again; on increasing dose to 80 mg/d, it disappeared. At 3 weeks, the patient was clinically normal. No relapse during 8 months of follow-up |
| 6. | Erickson JC et al., [20] 2002 | 34/M | Myorhythmia, myoclonus, and tremor | Primary hypothyroidism | Anti-TG+ Anti-TPO+ | No changes | IVMP followed by oral prednisolone | Moderate improvement with residual mild cognitive impairment and subtle facial myorhythmia |
| 7. | Erickson JC et al., [20] 2002 | 38/M | Palatal tremor | Euthyroid | Anti-TPO+ Anti-TG- | Venous anomaly in hypothalamus | IVMP followed by oral prednisolone | Moderate improvement in seizures, but cognitive impairment persisting |
| 8. | Nagpal T and Pande S [21] 2004 | 52/F | Parkinsonism and myoclonus | Subclinical hypothyroidism | Anti-TPO+ Anti-TG- | Cerebral atrophy | IVMP followed by oral prednisolone, PLEX, and finally by oral prednisolone | No improvement with IVMP; significant improvement 10days after PLEX |
| 9. | Loh LM et al., [22] 2005 | 40/M | Propriospinal or segmental myoclonus, Spasmodic truncal flexion | Primary hyperthyroid/Graves’ disease | TRAB+ Anti-TG+ TSI+ Anti-TPO- | No changes | Clonazepam and propylthiouracil | Euthyroidism established and symptoms improved |
| 10. | Tan EK et al., [23] 2006 | Middle aged/M | Bilateral postural hand tremor and task-specific dystonia-writer’s cramp | Primary hyperthyroidism/Graves’ disease | Anti-TG+ | No changes | Carbimazole | Euthyroidism achieved and symptoms improved |
| 11. | Guimaraes J et al., [24] 2007 | 60/M | Painful legs and moving toes syndrome, bradykinesia, and dystonia | Primary hypothyroidism | Anti-TG+ Anti-TPO+ | Subcortical white matter lesions | Oral prednisolone | No improvement |
| 12. | Tan EK et al., [25] 2008 | 50/F | Isolated orthostatic tremor | Primary hyperthyroidism/Graves’ disease | TRAB+ Anti-TG+ Anti-TPO+ | No changes | carbimazole | Complete resolution |
| 13. | Ku CR et al., [26] 2008 | 42/F | Generalized chorea | Primary hyperthyroidism/Graves’ disease | TRAB+ Anti-TG- Anti-TPO+ | No changes | IVMP, propylthiouracil, propranolol, trihexyphenidyl, ropinirole, clonazepam and quetiapine | Improved |
| 14. | Yu JH and Weng YM [27] 2009 | 17/F | Chorea | Primary hyperthyroidism/Graves’ disease | Anti-TPO+ | SPECT revealed decreased perfusion to the right anterior temporal cortex | Propylthiouracil and propranolol | Complete resolution |
| 15. | Broch L and Amthor KF [28] 2010 | 66/F | Myoclonus, tremor | Euthyroid | Anti-TPO++ | No changes | Systemic steroids | Improved |
| 16. | Salazar R et al., [29] 2012 | 59/M | Opsoclonus and gait ataxia | Euthyroid | Anti-TG+ Anti-TPO+ | No changes | IVIG/IVMP | After three months of therapy with corticosteroids improved, but not with IVIG |
| 17. | Liu MY et al., [30] 2012 | 75/M | Paroxysmal kinesigenic dyskinesia | Unknown | Anti-TPO+ | No changes | IVMP followed by oral prednisone taper | Back to baseline in 20days |
| 18. | Inoue K et al., [31] 2012 | 63/F | Micrography, parkinsonian gait and tremor | Euthyroid | Anti-TPO+ | White matter ischemic changes | IVMP followed by oral prednisolone | Improved |
| 19. | Ryan SA et al., [32] 2012 | 48/M | Myoclonus | Subclinical hypothyroidism | Anti-TPO++ Anti-TG- | No changes | Oral prednisolone | Improved |
| 20. | Park J et al., [33] 2012 | 16/M | Asymmetric chorea | Primary hyperthyroidism/Graves’ disease | TRAB+ Anti-TG+ | No changes | Propylthiouracil and propranolol | Improved |
| 21. | Nakavachara P et al., [34] 2013 | 14/M | Choreo-athetosis | Primary hyperthyroidism/Graves’ disease | Anti-TPO+ Anti-TG+ | No data available | Methimazole, propranolol, and IV potassium | Improved |
| 22. | Kaminska A et al., [35] 2013 | 23/F | Hemi-chorea | Primary hyperthyroidism/Graves’ disease | TRAB+ Anti-TPO+ | No changes | Thiamazole, prednisolone, haloperidol, thioridazine | Subsidence of symptoms |
| 23. | Ghoreishi E et al., [36] 2013 | 32/M | Palatal myoclonus | Euthyroid | Anti-TG+ Anti-TPO+ | Bilateral striatal hyperintensity on T2WI | Oral prednisolone | Improved |
| 24. | Philip R et al., [37] 2014 | 18/M | Myoclonus and tremor | Primary hyperthyroidism | Anti-TPO+ | Non-specific white matter changes and pituitary hyperplasia | IVMP followed by oral prednisolone and L-thyroxin | Significant improvement |
| 25. | Saygi S et al., [38] 2014 | 12/M | Motor tics | Euthyroid | Anti-TPO++ Anti-TG+ | No changes | Oral prednisolone | Improved |
| 26. | Rozankovic PB et al., [39] 2015 | 27/F | Myoclonus-Dystonia and choreo-athetosis | Euthyroid | Anti-TPO+ | No changes | IVMP followed by oral Prednisolone | Complete resolution |
| 27. | Lee HJ et al., [40] 2015 | 30/M | Ocular flutter, limb and gait ataxia, myoclonus, and truncal titubation | Euthyroid | Anti-TG+ Anti-TPO- | No changes | IVMP followed by oral prednisolone | Improved |
| 28. | Sharan A et al., [41] 2015 | 78/F | Choreiform movements | Euthyroid | Anti-TPO+ | Atrophy | IVMP followed by oral prednisolone | Improved |
| 29. | Sheetal SK et al., [42] 2016 | 66/M | Action-myoclonus, parkinsonism (corticobasal disease-variant-like) | Euthyroid | Anti-TPO+ Anti-TG- | Small right thalamic hematoma | IVMP followed by oral prednisolone | Improved |
| 30. | Ramcharan K et al., [43] 2016 | 34/F | Bilateral hand postural tremor | Euthyroid | Anti-TG+ TRAB+ Anti-TPO- | No changes | Oral prednisolone | Improved |
| 31. | Correia I et al., [44] 2016 | 61/F | Limb myoclonus | Primary hypothyroidism | Anti-TPO+ | SPECT revealed hypoperfusion in frontal, temporal, and parietal regions with left predominance | L-thyroxin, IVMP followed by oral prednisolone and azathioprine | Resolution |
| 32. | Kelly DM et al., [45] 2017 | 64/M | Abdominal tremor and abdominal wall dyskinesia | Primary hyperthyroidism | Anti-TPO+ | No changes | Carbimazole and supportive | Complete resolution |
| 33. | Keshavaraj A and Anpalagan J [46] 2018 | 23/F | Oro-lingual dyskinesia | Primary hyperthyroidism | Anti-TPO+ TRAB+ | No changes | IVMP, carbimazole, and propranolol | Significant improvement |
| 34. | Miranda M et al., [47] 2018 | 34/F | Choreo-athetosis, dystonia and ataxia | Euthyroid | Anti-TG+ Anti-TPO+ | No changes | IVMP and IVIG | Complete resolution |
| 35. | Miranda M et al., [47] 2018 | 61/M | Myoclonus-dystonia | Euthyroid | Anti-TPO+ | No changes | IVMP, IVIG, PLEX and rituximab | Incomplete resolution |
| 36. | Mohd Fauz NA et al., [48] 2019 | 50/F | Relapsing-remitting opsoclonus-myoclonus-ataxia syndrome | Subclinical hyperthyroidism | Anti-TG- Anti-TPO+ | Lesions in cortical and subcortical regions, pons and midbrain | IVMP and PLEX | Improved |
| 37. | Delhasse S et al., [49] 2019 | 60/F | Complex dyskinesia, high-amplitude myoclonic jerks, mild chorea, and postural tremor | Primary hyperthyroid/Graves’ disease | TRAB+ Anti-TG+ Anti-TPO+ Isotope scan+ | No changes | Carbimazoleàpropylthiouracilàradio-active iodine | Complete resolution |
| 38. | ShreeS et al., [50] 2020 | 60/F | Tremor, myoclonus and catatonia | Euthyroid | Anti-TPO+ | No changes | IVMP followed by oral prednisolone. | Improved |
[i] F: female; M: male; Anti-TPO: anti-thyroid peroxidase antibody; Anti-TG: anti-thyroglobulin antibody; TSI: thyroid stimulating immunoglobulin; TRAB: TSH receptor antibody; CSF: cerebrospinal fluid; SPECT: Single-photon emission computed tomography; IV: intravenous; MP: methylprednisolone; IG: immunoglobulin; PLEX: plasma exchange; MRI: magnetic resonance imaging; ‘+’: high/positive titer; ‘–’: low/negative titer.