Neuro-psychiatric manifestations of hashimoto thyroiditis; a case series

ABSTRACT

Hashimoto Encephalopathy [HE] or Steroid-Responsive Encephalopathy associated with Autoimmune Thyroiditis [SREAT] is a rare autoimmune disease characterized by encephalopathy and elevated anti-thyroid antibodies in the absence of a central nervous system [CNS] infection, tumour or stroke. Clinical presentation of HE includes amnestic syndrome, seizures including status epilepticus, ataxia, myoclonus and psychiatric manifestations like depression, mania, psychosis and hallucinations. A good clinical response can be achieved with corticosteroid therapy so early diagnosis and treatment is very beneficial for patients. Here we report four patients with Hashimoto encephalopathy who had neuro-psychiatric manifestations of the disease and had detectable thyroid specific antibodies in the serum [thyroperoxidase antibody formerly known as antimicrosomal antibody]. All these patients showed an objectively significant response to methylprednisolone treatment