Hormone Responsive Hashimoto Encephalopathy: A Case of Hashimoto Encephalopathy Treated with only Oral Thyroid Medication and Symptomatic Therapy for Seizures and Psychosis, but without Steroids

Hashimoto encephalopathy is a rare disease associated with autoimmune thyroiditis. Symptoms may include delirium, encephalopathy, seizures, and psychosis. Pathophysiology of this disease is not completely understood. This condition is often under-diagnosed if not suspected and should be considered in patients with diverse neuropsychiatric manifestations in whom no obvious etiology of encephalopathy can be determined. Anti-thyroid antibodies and thyroid peroxidase antibodies are crucial for diagnosis. Along with supportive management, empiric steroid treatment is usually administered as soon as infectious and other causes are ruled out. We report a case of Hashimoto thyroiditis which presented with agitation, psychosis, hallucinations, complex partial seizures. In this case the disease was controlled with only oral thyroid therapy and supportive management with antiepileptic drugs and antipsychotic drugs, but without the use of steroids.