Hashimoto encephalopathy in the intensive care unit: do not miss it!

Abstract

Hashimoto’s encephalopathy (HE) is a rare clinical entity, mostly observed in women. HE associates neuropsychiatric manifestations, elevated serum concentration of antithyroid antibodies, and responsiveness to glucocorticoid therapy. Diagnosis is frequently delayed due to the lack of specific neurological symptoms. It is frequently assessed in the intensive care unit (ICU) once the disease has progressed to a life-threatening neurological condition. HE suspicion in an ICU patient should be raised in the presence of coma, seizures or status epilepticus requiring mechanical ventilation. Corticosteroids should be promptly started, generally resulting in clinical improvement over days or weeks.