Hashimoto’s Encephalopathy: An Unusual Cause of Autoimmune Encephalopathy in a Clinically and Biochemically Euthyroid Patient

Authors

• Senthil Chandrasekaram Department of Endocrinology and Diabetes, King’s Mill Hospital, Sherwood Forest Hospital NHS Foundation Trust, Sutton-in-Ashfield
• Emily Mudenha Department of Endocrinology and Diabetes, King’s Mill Hospital, Sherwood Forest Hospital NHS Foundation Trust, Sutton-in-Ashfield
• Buddhike A Mendis Department of Endocrinology and Diabetes, King’s Mill Hospital, Sherwood Forest Hospital NHS Foundation Trust, Sutton-in-Ashfield
• Antal Szabo Department of Endocrinology and Diabetes, King’s Mill Hospital, Sherwood Forest Hospital NHS Foundation Trust, Sutton-in-Ashfield
• Devaka JS Fernando Department of Endocrinology and Diabetes, King’s Mill Hospital, Sherwood Forest Hospital NHS Foundation Trust, Sutton-in-Ashfield Department of Diabetes and Endocrinology, University of Sheffield, Sheffield Postgraduate Medical Centre, Sheffield Hallam University, Sheffield

devaka.fernando@sfh-tr.nhs.uk

Abstract

Objectives: To highlight the occurrence of Hashimoto’s encephalopathy – a steroid-responsive encephalopathy associated with elevated antithyroid antibodies.
Material and methods: We describe a clinically and biochemically euthyroid patient with an encephalopathy presenting with headache, mild confusion and personality changes for 6 weeks and tonic–clonic seizures upon admission.
Results: There was no obvious infective or metabolic cause. The patient had a high titre of antithyroid antibodies and responded to steroid therapy.
Conclusion: This uncommon disease needs to be considered in patients presenting with neurological symptoms that remain unexplained after routine standard investigations, even when the patient is euthyroid. Early diagnosis is important, as this is a treatable condition.

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