• Annals of Clinical Neurophysiology
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• v.16 no.2
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• pp.70-73
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• 2014

Nonconvulsive status epilepticus usually presents with altered mentation without distinct manifestations of seizures. It may be related with various medical disorders. Hashimoto's encephalopathy is characterized by various neurological manifestations accompanied by high titers of anti-thyroid antibodies. Here, we report a patient with nonconvulsive status epilepticus caused by Hashimoto's encephalopathy who showed a dramatic response to steroids.

• Annals of Clinical Neurophysiology
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• v.9 no.2
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• pp.85-88
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• 2007

Hashimoto's encephalopathy has been described as a steroid-responsive syndrome of encephalopathy associated with high serum concentration of anti-thyroid antibodies. We report a 67-year-old woman who presented with myoclonus involving both upper extremities. Brain MRI and EEG showed no diagnostic abnormalities. Thyroid functions were normal, but anti-thyroid antibodies were elevated both in serum and in CSF. Hashimoto's encephalopathy can present with myoclonus even without outstanding encephalopathic feature, therefore anti-thyroid antibody test should be included in diagnostic test in patient with myoclonus.

• Clinical and Experimental Pediatrics
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• v.55 no.3
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• pp.111-113
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• 2012

Hashimoto's encephalopathy (HE) is a rare, poorly understood, autoimmune disease characterized by symptoms of acute or subacute encephalopathy associated with increased anti-thyroid antibody levels. Here, we report a case of a 14-year-old girl with HE and briefly review the literature. The patient presented with acute mental changes and seizures, but no evidence of infectious encephalitis. In the acute stage, the seizures did not respond to conventional antiepileptic drugs, including valproic acid, phenytoin, and topiramate. The clinical course was complicated by the development of acute psychosis, including bipolar mood, insomnia, agitation, and hallucinations. The diagnosis of HE was supported by positive results for antithyroperoxidase and antithyroglobulin antibodies. Treatment with methylprednisolone was effective; her psychosis improved and the number of seizures decreased. HE is a serious but curable, condition, which might be underdiagnosed if not suspected. Anti-thyroid antibodies must be measured for the diagnosis. HE should be considered in patients with diverse neuropsychiatric manifestations.

• Annals of Clinical Neurophysiology
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• v.22 no.1
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• pp.24-28
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• 2020

Hashimoto's encephalopathy (HE) is a heterogeneous encephalopathy with diverse clinical presentations. Here we report on a 69-year-old woman who presented with confusion, aphasia, fever, and focal ictal discharges. Cerebrospinal fluid analysis and a workup for other fever origins revealed no abnormality and a high level of thyroperoxidase antibody was detected, which findings led to a diagnosis of HE. The symptoms subsided after treatment. This study highlights the importance of considering HE in patients presenting with fever and abnormal EEG findings.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.30 no.1
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• pp.42-44
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• 2019

Hashimoto's encephalopathy (HE) is a rare and underdiagnosed neuropsychiatric illness. We present the case of a 17-year-old girl who was admitted to a tertiary-care psychiatric center with acute onset psychosis and fever. Her psychotic symptoms were characterized by persecutory and referential delusions, as well as tactile and visual hallucinations. Her acute behavioral disturbance warranted admission and treatment in a psychiatric setting (risperidone tablets, 3 mg/day). She had experienced an episode of fever with a unilateral visual acuity defect approximately 3 years before admission, which was resolved with treatment. Focused clinical examination revealed an enlarged thyroid, and baseline blood investigations, including thyroid function test results were normal. Abnormal laboratory investigations revealed elevated anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) levels (anti-TPO of 480 IU/mL; anti-TG of 287 IU/mL). Results of other investigations for infection, including cerebrospinal fluid examination, electroencephalography, and brain magnetic resonance imaging were normal. She was diagnosed with HE and was treated with intravenous corticosteroids (methylprednisolone up to 1 g/day; tapered and discontinued after a month). The patient achieved complete remission of psychotic symptoms and normalization of the anti-thyroid antibody titers. Currently, at the seventh month of follow-up, the patient is doing well. This case highlights the fact that in the absence of well-defined clinical diagnostic criteria, a high index of suspicion is required for early diagnosis of HE. Psychiatrists need to explore for organic etiologies when dealing with acute psychiatric symptoms in a younger age group.

• Journal of the Korean Society of Radiology
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• v.81 no.2
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• pp.453-458
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• 2020

Hashimoto's encephalopathy (HE) is a rare autoimmune disease characterized by a high serum concentration of antithyroid antibodies without evidence of cerebral disease. Magnetic resonance imaging (MRI) findings in HE patients are nonspecific, although diffuse or focal white matter changes have been reported in several cases. We present a rare case involving a 79-year-old woman with elevated antithyroid antibody levels and abnormal imaging findings similar to meningoencephalitis. Serial MRI initially showed multiple T2 hyperintense lesions with diffuse leptomeningeal enhancement that disappeared after steroid therapy.