Super refractory status epilepticus as an atypical presentation of Hashimoto’s encephalopathy
Hashimoto's encephalopathy (HE), also known as steroid responsive encephalopathy associated with autoimmune thyroiditis (SREAT), is a rare autoimmune disorder characterized by neuropsychiatric manifestations and a favorable response to corticosteroids. Seizures occur in nearly half of patients;...
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2026
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| author | Chaponan-Lavalle, Andres Alave Rosas, Jorge Luis Fernandez, Fred Chacon Hermoza, Luciana Barrientos-Iman, Danny M. Chulluncuy-Rivas, Roberto Diaz Reyes, Nelson Fidel |
| author_browse | Alave Rosas, Jorge Luis Barrientos-Iman, Danny M. Chacon Hermoza, Luciana Chaponan-Lavalle, Andres Chulluncuy-Rivas, Roberto Diaz Reyes, Nelson Fidel Fernandez, Fred |
| author_facet | Chaponan-Lavalle, Andres Alave Rosas, Jorge Luis Fernandez, Fred Chacon Hermoza, Luciana Barrientos-Iman, Danny M. Chulluncuy-Rivas, Roberto Diaz Reyes, Nelson Fidel |
| author_sort | Chaponan-Lavalle, Andres |
| collection | Producción científica |
| description | Hashimoto's encephalopathy (HE), also known as steroid responsive encephalopathy associated with autoimmune thyroiditis (SREAT), is a rare autoimmune disorder characterized by neuropsychiatric manifestations and a favorable response to corticosteroids. Seizures occur in nearly half of patients; however, super refractory status epilepticus (SRSE) is an uncommon initial presentation. We describe a young adult woman with Hashimoto's thyroiditis who developed SRSE after a brief prodrome of headache, confusion, and paranoia. Extensive infectious, metabolic, and autoimmune workup was negative, but anti-thyroid peroxidase and anti-thyroglobulin antibodies were markedly elevated. Brain MRI showed nonspecific subcortical T2/FLAIR hyperintensities. The patient was diagnosed with HE and treated with high dose intravenous methylprednisolone followed by intravenous immunoglobulin, resulting in full neurological recovery and sustained seizure freedom at three-month follow up. This case illustrates the importance of considering HE in patients with unexplained SRSE, as prompt recognition and immunotherapy can be lifesaving. |
| format | Article |
| id | oai:cris.upeu.edu.pe:20.500.15037/139 |
| institution | UPeU |
| language | English |
| publishDate | 2026 |
| publishDateRange | 2026 |
| publishDateSort | 2026 |
| record_format | dspace |
| spelling | oai:cris.upeu.edu.pe:20.500.15037/1392026-11-02T12:57:04ZSuper refractory status epilepticus as an atypical presentation of Hashimoto’s encephalopathyChaponan-Lavalle, AndresAlave Rosas, Jorge LuisFernandez, FredChacon Hermoza, LucianaBarrientos-Iman, Danny M.Chulluncuy-Rivas, RobertoDiaz Reyes, Nelson FidelImmunotherapyAutoimmunethyroiditisHashimoto’SencephalopathyResponsiveencephalopathySuperrefractorystatusepilepticusHashimoto's encephalopathy (HE), also known as steroid responsive encephalopathy associated with autoimmune thyroiditis (SREAT), is a rare autoimmune disorder characterized by neuropsychiatric manifestations and a favorable response to corticosteroids. Seizures occur in nearly half of patients; however, super refractory status epilepticus (SRSE) is an uncommon initial presentation. We describe a young adult woman with Hashimoto's thyroiditis who developed SRSE after a brief prodrome of headache, confusion, and paranoia. Extensive infectious, metabolic, and autoimmune workup was negative, but anti-thyroid peroxidase and anti-thyroglobulin antibodies were markedly elevated. Brain MRI showed nonspecific subcortical T2/FLAIR hyperintensities. The patient was diagnosed with HE and treated with high dose intravenous methylprednisolone followed by intravenous immunoglobulin, resulting in full neurological recovery and sustained seizure freedom at three-month follow up. This case illustrates the importance of considering HE in patients with unexplained SRSE, as prompt recognition and immunotherapy can be lifesaving.Articlehttps://pubmed.ncbi.nlm.nih.gov/41908686https://doi.org/10.1016/j.ebr.2026.100862PMC1302009610.1016/j.ebr.2026.100862https://hdl.handle.net/20.500.15037/13941908686W7136463680enEpilepsy & Behavior Reports2589-98642026-03-162026-06-13T07:48:06Z2026-06-13T07:48:06Z |
| spellingShingle | Immunotherapy Autoimmunethyroiditis Hashimoto’Sencephalopathy Responsiveencephalopathy Superrefractorystatusepilepticus Chaponan-Lavalle, Andres Alave Rosas, Jorge Luis Fernandez, Fred Chacon Hermoza, Luciana Barrientos-Iman, Danny M. Chulluncuy-Rivas, Roberto Diaz Reyes, Nelson Fidel Super refractory status epilepticus as an atypical presentation of Hashimoto’s encephalopathy |
| title | Super refractory status epilepticus as an atypical presentation of Hashimoto’s encephalopathy |
| title_full | Super refractory status epilepticus as an atypical presentation of Hashimoto’s encephalopathy |
| title_fullStr | Super refractory status epilepticus as an atypical presentation of Hashimoto’s encephalopathy |
| title_full_unstemmed | Super refractory status epilepticus as an atypical presentation of Hashimoto’s encephalopathy |
| title_short | Super refractory status epilepticus as an atypical presentation of Hashimoto’s encephalopathy |
| title_sort | super refractory status epilepticus as an atypical presentation of hashimoto s encephalopathy |
| topic | Immunotherapy Autoimmunethyroiditis Hashimoto’Sencephalopathy Responsiveencephalopathy Superrefractorystatusepilepticus |
| topic_facet | Immunotherapy Autoimmunethyroiditis Hashimoto’Sencephalopathy Responsiveencephalopathy Superrefractorystatusepilepticus |
| url | https://pubmed.ncbi.nlm.nih.gov/41908686 https://doi.org/10.1016/j.ebr.2026.100862 https://hdl.handle.net/20.500.15037/139 |
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