An Unusual Cause for Altered Sensorium - A Case Report

Hashimotos encephalopathy is an autoimmune disorder, with high titres of antithyroid peroxidase antibody, usually with a clinically and biochemically normal thyroid function. Here we present a case of hashimotos encephalopathy in a 34yr old man, who presented with acute onset of cognitive impairment on a background of psychiatric illness. Initially a probability of neuroleptic malignant syndrome and CNS infection were entertained, but finally patient had high titres of anti thyroid peroxidase antibodies. Hence, we should ascertain different differentials, and a high level of suspicion is required to diagnose hashimotos encephalopathy, unlike other autoimmune disorder. Though more common among female population, it should be encouraged as a differential even in male.