Jung-Ju Lee; Kyusik Kang; Jong-Moo Park; Hyeeun Shin; Ohyun Kwon; Byung Kun Kim

doi:10.14253/kjcn.2014.16.2.70

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Lee, Kang, Park, Shin, Kwon, and Kim: Nonconvulsive Status Epilepticus Associated with Hashimoto’s Encephalopathy

Case Report

Korean J Community Nutr 2014;16(2):70-73.

Published online: 18 January 2014

DOI: https://doi.org/10.14253/kjcn.2014.16.2.70

Nonconvulsive Status Epilepticus Associated with Hashimoto’s Encephalopathy

Jung-Ju Lee, Kyusik Kang, Jong-Moo Park, Hyeeun Shin, Ohyun Kwon, Byung Kun Kim

Department of Neurology, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea

Address for correspondence; Byung-Kun Kim Department of Neurology, Eulji Hospital, Eulji University School of Medicine, 68 Hangeulbiseok-ro, Noweon-gu, Seoul 139-711, Korea Tel: +82-2-970-8312 Fax: +82-2-974-7785 E-mail: kimbkun1403@gmail.com

Received 25 November 2013 Revised 25 March 2014 Accepted 13 October 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Nonconvulsive status epilepticus usually presents with altered mentation without distinct manifestations of seizures. It may be related with various medical disorders. Hashimoto’s encephalopathy is characterized by various neurological manifestations accompanied by high titers of anti-thyroid antibodies. Here, we report a patient with nonconvulsive status epilepticus caused by Hashimoto’s encephalopathy who showed a dramatic response to steroids. (Korean J Clin Neurophysiol 2014;16:70-73)

Keywords: Nonconvulsive status epilepticus, Hashimoto’s encephalopathy, Immunologic treatment

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Figure 1.

Diffusion MRI shows no acute lesion other than remnant tumor and minimal hematoma in left pons and cerebellum.

Figure 2.

Frequent sharp-and-slow waves are observed in the left occipital area (A). Intermittent rhythmic delta activity in the left occipital area spreads to the right occipital and bilateral frontotemporal area with evolution to higher amplitude (B).

Figure 3.

Frequent sharp-and-slow waves in the left occipital area spread to the right occipital area and the left frontotemporal area with evolving to semirhythmic delta activity (A). Rhythmic sharp and slow waves sometimes appeared in the left or right frontotemporal area (B).

Figure 4.

Follow-up EEG after steroid pulse therapy. Background alpha rhythms are well regulated with a little amount of intermittent frontotemporal slowing. EEG; electroencephalogram.

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