Abstract: Two teenage girls with episodic neuropsychiatric symptoms, altered
consciousness, collapse and seizures requiring intensive care admissions are
presented. Both were euthyroid at presentation and had markedly elevated
anti-thyroperoxidase antibody. Extensive neurometabolic tests and cranial
imaging were normal. However, psychometric testing showed evidence of memory
and cognitive difficulties. Both were diagnosed as Hashimoto encephalopathy and
one improved after steroid treatment while the other was lost to follow-up
after defaulting scheduled elective hospital admission for steroid therapy.
Keywords: Hashimoto encephalopathy, antithyroid antibodies, status epilepticus