title: Hashimoto Encephalopathy Presenting With Stroke-Like Episodes in an Adolescent Female: A Case Report and Literature Review.
abstract: Hashimoto encephalopathy is a rare form of encephalopathy thought to be of autoimmune etiology. Cognitive changes and seizures are the most commonly reported presenting manifestation. Stroke-like episodes have also been documented in these individuals. We describe a rare adolescent with Hashimoto encephalopathy who presented with stroke-like symptoms.
  
  
  
  A previously well 15-year-old girl experienced sudden-onset language disturbance and right hemiparesis. Her symptoms resolved, but weeks later, she began experiencing refractory seizures, episodes of status epilepticus, and cognitive decline. An extensive evaluation was unremarkable, but thyroid peroxidase antibodies were elevated, and a diagnosis of Hashimoto encephalitis was made. Steroid therapy was initiated, and her symptoms resolved with return to baseline cognitive function.
  
  
  
  Hashimoto encephalopathy is a highly treatable condition that may be considered in the differential diagnosis of children and adolescents presenting with stroke-like symptoms.
authors.affiliation: Department of Medicine, Division of Neurology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. Electronic address: brett.graham@usask.ca.
authors.forename: Brett R
authors.initials: BR
authors.lastname: Graham
authors.affiliation: Department of Pediatrics, Division of Rheumatology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
authors.forename: Natalie
authors.initials: N
authors.lastname: Shiff
authors.affiliation: Department of Pediatrics, Division of Endocrinology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
authors.forename: Munier
authors.initials: M
authors.lastname: Nour
authors.affiliation: Department of Pediatrics, Division of Neurology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
authors.forename: Simona
authors.initials: S
authors.lastname: Hasal
authors.affiliation: Department of Pediatrics, Division of Neurology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
authors.forename: Richard
authors.initials: R
authors.lastname: Huntsman
authors.affiliation: Department of Pediatrics, Division of Neurology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
authors.forename: Salah
authors.initials: S
authors.lastname: Almubarak
mesh_terms: D000293:Adolescent; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology; D003937:Diagnosis, Differential; D004660:Encephalitis / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D050031:Hashimoto Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D020521:Stroke / Q000175:diagnosis
keywords: Hashimoto encephalopathy; autoimmune encephalopathy; autoimmune thyroiditis; steroid-responsive encephalopathy; stroke