Myxoedema presenting with seizures

The case of a 32 year old female who presented with her first epileptic fit and took over 36 hours to recover is described. Investigations led to a diagnosis of hypothyroidism as the cause. Following treatment with thyroxine she has remained well with no further fits for over 2 years. Hypothyroidism should be considered as a possible underlying cause of epilepsy especially when there is a prolonged recovery time after a fit.