A Case of Hashimoto’s Encephalopathy in a Patient with Lithium Toxicity

Hashimoto’s encephalopathy (HE) is an uncommon neurological syndrome associated with Hashimoto’s thyroiditis, first reported by Brain et al in 1966. The disorder occurs more frequently between age 44 to 46 years, with a female to male ratio of 4:1. The clinical presentation may involve relapsing remitting course and include stroke like episodes, cognitive decline, neuropsychiatric symptoms, seizures and myoclonus. Thyroid status may vary from hyperthyroid, euthyroid to hypothyroid. Treatment with corticosteroids is almost always successful. Other forms of immunomodulation, such as intravenous immune-globulin and plasma exchange, may also be effective. We presented a case of hashimoto’s encephalopathy in a patient of known bipolar disorder with lithium toxicity.