A Case of Hashimoto Encephalopathy Presented with Seizure

Hashimoto encephalopathy (HE) is a steroid-responsive but relapsing neuropsychiatric disorder associated with high titers of antithyroid antibody with or without thyroid dysfunction. Though numerous neurological manifestations are often associated with thyroid disorder, this entity is less documented. We are reporting a case of HE in a 63 year old female presenting with sudden onset focal seizure following an attack of mild fever. Other causes of vascular, infective, metabolic, autoimmune and toxic encephalopathy were excluded. MRI of brain revealed oedematous gyri of left medial temporal lobe with diffuse age related brain atrophy. Patient's thyroid function tests were normal but anti thyroid peroxidase (anti-TPO) antibody was signicantly raised. EEG showed diffuse slow wave pattern. After suspecting diagnosis of HE, Intravenous methylprednisolone (one gram) given for ve days. Patient regained consciousness slowly over a period of one week. HE must be kept in mind in comatose patients when other metabolic, infective and structural neurological causes have been excluded. Proper and timely treatment can salvage the patient