Hashimoto’s Encephalopathy: A Remediable Cause of Unexplained Encephalopathy

Hashimoto’s encephalopathy is non-vasculitic autoimmune steroid responsive encephalopathy. It is an uncommon syndrome characterized by altered level of consciousness, confusion, seizures and myoclonus. Exact pathogenesis is yet to be determined though humoral hyper-immune response is favored mechanism rather than dysthyroidism. We present a case of Hashimoto’s encephalopathy in an eighty years old lady who presented with unexplained drowsiness. Extensive workup for the cause of drowsiness was carried outto find structural, metabolic, autoimmune or para-neoplastic etiology only to reveal high titers of anti-TPO antibodies. Patient responded remarkably to high dose steroids.