Patients with hemispatial neglect may also fail to recognize paralyzed parts of their bodies:  one frequently mentioned case is of a man who repeatedly tried to throw his own paralyzed right leg out of the bed he was lying in, and when asked what he was doing, complained that somebody had put a dead leg into the bed with him. An even more striking type of anosognosia is Anton–Babinski syndrome, a rarely occurring condition in which patients become blind but claim to be able to see normally, and persist in this claim in spite of all evidence to the contrary. Stream of consciousness
William James is usually credited with popularizing the idea that human consciousness flows like a stream, in his Principles of Psychology of 1890. According to James, the "stream of thought" is governed by five characteristics:
Every thought tends to be part of a personal consciousness. Within each personal consciousness thought is always changing. Within each personal consciousness thought is sensibly continuous. It always appears to deal with objects independent of itself. It is interested in some parts of these objects to the exclusion of others.A similar concept appears in Buddhist philosophy, expressed by the Sanskrit term Citta-saṃtāna, which is usually translated as mindstream or "mental continuum". Buddhist teachings describe that consciousness manifests moment to moment as sense impressions and mental phenomena that are continuously changing. The teachings list six triggers that can result in the generation of different mental events.
Since enolase is the penultimate step in glycolysis, if it were inhibited (for example by being bound by autoantibodies), one would expect decreased energy production by each cell, leading to resulting atrophy of the affected organ.This would occur most likely through each cell shrinking in size in response to the energy deficit (and/or in extreme situations from some cells dying via either apoptosis or necrosis, depending on location). This may occur as a result of enough ATP not being available to maintain cellular functions - notably, failure of the Na/K ATPase, resulting in a loss of the gradient to drive the Na/Ca antiporter, which normally keeps Ca+2 out of cells so it does not build to toxic levels that will rupture cell lysosomes leading to apoptosis. An additional feature of a low-energy state is failure to maintain axonal transport via dynein/kinesin ATPases, which in many diseases results in neuronal injury to both the brain and/or periphery. Pathology
Very little is known about the pathology of Hashimotos encephalopathy. Post mortem studies of some individuals have shown lymphocytic vasculitis of venules and veins in the brain stem and a diffuse gliosis involving gray matter more than white matter.As mentioned above, autoantibodies to alpha-enolase associated with Hashimotos encephalopathy have thus far been the most hypothesized mechanism of injury.