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Hashimoto's encephalopathy presenting with bipolar affective disorder.

Müssig K, Bartels M, Gallwitz B, Leube D, Häring HU, Kircher T

Division of Endocrinology, Metabolism and Pathobiochemistry, Department of Internal Medicine, University Hospital of Tübingen, Tübingen, Germany.

OBJECTIVE: We report on a rare case of Hashimoto's encephalopathy associated with a bipolar affective disorder. CASE REPORT: 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. CONCLUSION: 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.

Published 18 May 2005 in Bipolar Disord, 7(3): 292-7.
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