title: Hashimoto's encephalopathy presenting with bipolar affective disorder.
abstract: OBJECTIVE
  We report on a rare case of Hashimoto's encephalopathy associated with a bipolar affective disorder.
  
  
  METHODS
  A 32-year-old woman presented with a bipolar affective disorder and Hashimoto's thyroiditis. Neurological investigations (magnetic resonance imaging of the brain and cerebrospinal fluid) did not reveal any pathological findings except for a pathological electroencephalogram (EEG). Despite consequent antidepressant treatment, the patient remitted only in conjunction with normalization of the EEG after short-term treatment with high doses of prednisolone.
  
  
  CONCLUSIONS
  In treatment resistant courses of disorders, the thorough clinical and laboratory investigation of our patient revealed a very efficient treatment strategy. Cases of Hashimoto's encephalopathy associated with the occurrence of a manic episode and hence with bipolar disorder are rare; this is the first reported case. However, clinicians should be alert to this possibility.
authors.affiliation: Division of Endocrinology, Metabolism and Pathobiochemistry, Department of Internal Medicine, University Hospital of Tübingen, Tübingen, Germany.
authors.forename: Karsten
authors.initials: K
authors.lastname: Müssig
authors.forename: Mathias
authors.initials: M
authors.lastname: Bartels
authors.forename: Baptist
authors.initials: B
authors.lastname: Gallwitz
authors.forename: Dirk
authors.initials: D
authors.lastname: Leube
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Häring
authors.forename: Tilo
authors.initials: T
authors.lastname: Kircher
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D011239:Prednisolone / Q000627:therapeutic use; D013967:Thyroiditis, Autoimmune / Q000175:diagnosis* / Q000628:therapy
chemical_list: D011239:Prednisolone