A Case of Steroid-Responsive Encephalopathy

Area of Science:

• Neurology
• Immunology
• Endocrinology

Background:

• Hashimoto's encephalopathy (HE) is a rare neurological disorder linked to autoimmune thyroiditis.
• It typically manifests with gradual onset neurological symptoms over months.

Observation:

• The case involved a 74-year-old male with abrupt confusion.
• Diagnosis required identifying elevated anti-thyroid antibodies (anti-TPO or anti-M).
• Other findings included elevated ESR, liver enzymes, and CSF protein.

Findings:

• HE symptoms encompass cognitive decline, psychiatric disturbances, and motor deficits.
• Thyroid function tests and antibody titers do not correlate with disease severity.
• Cerebral imaging is often unremarkable.

Implications:

• Early diagnosis of HE is crucial for timely intervention.
• Steroids, IVIg, or plasmapheresis are effective treatments for HE.
• This case highlights the importance of considering autoimmune thyroiditis in encephalopathy presentations.