Autoimmune encephalitis associated with Graves' disease: a case report.

Area of Science:

• Neurology
• Endocrinology
• Immunology

Background:

• Autoimmune thyroid disease (AITD) is commonly associated with Hashimoto's thyroiditis and encephalopathy.
• Encephalopathy in patients with Graves' disease, a different form of AITD, is rarely reported.

Observation:

• A 36-year-old female with a decade-long history of Graves' disease presented with recurrent tonic-clonic seizures, confusion, and hallucinations.
• Cranial MRI revealed white-matter lesions and subcortical high signal abnormalities on T2-weighted images.
• EEG showed diffuse slow wave activity, and laboratory tests indicated decreased T3 and TSH levels with normal T4 and significantly elevated thyroid peroxidase antibodies (TPO >2,000).

Findings:

• The patient's presentation, neurological findings, and elevated TPO antibodies strongly suggested an autoimmune thyroid disease-associated encephalopathy.
• This case expands the understanding of AITD-related encephalopathy beyond Hashimoto's thyroiditis to include Graves' disease.

Implications:

• Diagnosing autoimmune thyroid disease is crucial for patients presenting with unexplained encephalopathy, especially those with a known history of thyroid dysfunction.
• This case underscores the need for comprehensive thyroid evaluation in patients with new-onset neurological deficits of unknown etiology.
• Further research is warranted to elucidate the mechanisms linking Graves' disease to encephalopathy and to establish optimal diagnostic and treatment strategies.