Hashimoto's encephalopathy presenting with bipolar affective disorder


  • The authors of this paper do not have any commercial associations that might pose a conflict of interest in connection with this manuscript.

Tilo Kircher, MD, Klinik für Psychiatrie und Psychotherapie der RWTH Aachen, Pauwelssstr. 30, 52074 Aachen, Germany. Fax: +49 0 241 80 89 633; e-mail: tkircher@ukaachen.de


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.