Hashimoto's encephalopathy misdiagnosed as pyogenic meningoencephalitis: Hashimoto’s encephalopathy

Naveed Mohsin; Javvid Muzamil Dandroo; Nawaz Ahmad Sheikh

Authors

Naveed Mohsin Department of General Medicine, Sher‑I‑Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
Javvid Muzamil Dandroo Department of General Medicine, Sher‑I‑Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
Nawaz Ahmad Sheikh Department of General Medicine, Sher‑I‑Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India

Keywords:

Cerebrospinal fluid, Hashimoto encephalopathy, nonvasculitic autoimmune meningoencephalitis, steroid-responsive encephalopathy

Abstract

Hashimoto's encephalopathy is a controversial and under-recognized condition, associated with autoimmune thyroiditis. Presentation may be an insidious development of cognitive impairment or recurrent acute episodes of focal neurological deficit with confusion. Here, we present a case of middle-aged female that presented with headache, vomiting with alteration of sensorium and left side weakness and responded well to steroids. A negative microbiological screen of the cerebrospinal fluid (CSF) and serum along with raised CSF protein, elevated serum antithyroid antibodies, and characteristic electroencephalographic and neuroimaging findings yielded the diagnosis.

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Hashimoto's encephalopathy misdiagnosed as pyogenic meningoencephalitis