Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Medicine
Volume 2017 (2017), Article ID 3494310, 3 pages
https://doi.org/10.1155/2017/3494310
Case Report

Hashimoto’s Encephalopathy Presenting with Unusual Behavioural Disturbances in an Adolescent Girl

Department of Psychiatry, Sri Ramachandra Medical College & Research Institute, Sri Ramachandra University, Chennai, India

Correspondence should be addressed to Murugan Selvaraj Karthik; moc.liamg@8002smkihtrakrd

Received 6 January 2017; Revised 14 March 2017; Accepted 16 April 2017; Published 21 May 2017

Academic Editor: Mark E. Shaffrey

Copyright © 2017 Murugan Selvaraj Karthik et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hashimoto’s encephalopathy (HE) is a rare autoimmune disorder with neurological and neuropsychiatric manifestations and elevated titres of anti-thyroid antibodies. Here we are reporting a case of HE in a 19-year-old girl who presented with seizure-like episodes, confusion, and behavioural disturbances with catatonic symptoms such as posturing, echopraxia, echolalia, and ambivalence. Patient did not respond to antipsychotics and anticonvulsants. On further investigation, patient was found to have high serum anti-TPO antibodies of about 1261 U/mL with euthyroid status, which supported a suspicion of HE. Our consultant neurologist confirmed the diagnosis and she was started on injection of methylprednisolone 750 mg OD. Since patient started showing clinical improvement, her antipsychotic medications were tapered off. On follow-up, patient has recovered and is functioning well. Since HE is a diagnosis of exclusion, very high anti-TPO antibodies and good response to steroids supported the diagnosis of HE in this patient after excluding other etiological possibilities. This case has been reported because the clinical presentation was predominantly neurobehavioural manifestations which is uncommon with HE.