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Hashimoto's encephalopathy presenting with neurocognitive symptoms: a case report

Carlos Canelo-Aybar*, David Loja-Oropeza, Jose Cuadra-Urteaga and Franco Romani-Romani

Author Affiliations

Department of Medicine, Arzobispo Loayza Hospital, Lima, Peru

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Journal of Medical Case Reports 2010, 4:337  doi:10.1186/1752-1947-4-337

Published: 25 October 2010

Abstract

Introduction

Hashimoto's encephalopathy is a neurological disorder of unknown cause associated with thyroid autoimmunity. The disease occurs primarily in the fifth decade of life and may present in two types - a sudden vasculitic type or a progressive subacute type associated to cognitive dysfunction, confusion and memory loss.

Case presentation

We report the case of a 62-year-old Hispanic woman, previously healthy, who developed a subacute onset of declining upper brain function. Serologic studies demonstrated high levels of antithyroid antibodies. Electroencephalographic and magnetic resonance image findings were consistent with Hashimoto's encephalopathy.

Conclusion

Hashimoto's encephalopathy is a diagnosis of exclusion. This unusual disorder is often under-recognized because of the multiple and protracted neurocognitive manifestations; therefore, it is important to be aware of the clinical manifestations to make a correct diagnosis.