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Psychosomatic Medicine 69:200-201 (2007)
© 2007 American Psychosomatic Society

CASE REPORT

Psychiatric Presentation of Hashimoto's Encephalopathy

Manuel Arrojo, MD, Maria M. Perez-Rodriguez, MD, Márcia Mota, MD, Ricardo Moreira, MD, Ana Azevedo, MD, Ana Oliveira, MD, Pedro Abreu, MD, Paula Marques, MD, Alzira Silva, MD, Jorge G. Pereira, MD, A. Pacheco Palha, MD and Enrique Baca-Garcia, MD

From the Departments of Psychiatry (M.A., M.M., R.M., A.S., A.P.P.), Internal Medicine (A.A., P.M.), Nuclear Medicine (A.O., J.G.P.), Neurology (P.A.), Hospital S. João, Alameda Prof Hernani Monteiro, Porto, Portugal; the Department of Psychiatry (M.M.P.-R.), Ramón y Cajal University Hospital, Madrid, Spain; and the Department of Neuroscience (E.B.-G.), Columbia University Medical Center, New York, NY.

Address correspondence and reprint requests to Enrique Baca-Garcia, Department of Neuroscience, Columbia University Medical Center, 1051 Riverside Drive, Suite 2917/unit 42, New York, NY 10032. E-mail: ebacgar2{at}yahoo.es; merperez{at}yahoo.com

Introduction: Hashimoto's encephalopathy is an unusual condition that is associated with Hashimoto's thyroiditis. Myoclonus, epileptic seizures, dementia, and disturbances of consciousness are the most common features.

Case report: We present an atypical case of Hashimoto's encephalopathy in a 33-year-old woman who presented with several brief and acute psychotic episodes. After treatment with steroids, there was an improvement in the patient's psychiatric symptoms and electroencephalogram, and antithyroglobulin antibody titers returned to normal levels.

Conclusions: It is our opinion that Hashimoto's encephalopathy should be considered in the differential diagnosis of atypical psychosis, especially because this is a treatable syndrome. This is particularly important in patients with a previous history of thyroid disease, despite current normal thyroid function.

Key Words: Hashimoto's disease • encephalopathy • single-photon emission-computed tomography • psychiatric symptoms

Abbreviations: CT = computed tomography; EEG = electroencephalogram.






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Copyright © 2007 by the American Psychosomatic Society