Hashimoto’s Encephalopathy with Reversible Diffuse Leukoencephalopathy

Case Report: A 57-year-old woman presented with a sudden onset of dysarthria and dizziness. Routine blood tests were normal and the MRI was unremarkable. After admission, she developed aphasic seizures and myoclonus, and eventually became comatose. A follow up MRI showed diffuse high signal intensities at the bilateral cerebral white matter on fluid attenuated inversion recovery imaging. The serum titers of the anti-thyroglobulin antibody and anti-thyroperoxidase antibody were increased. After 5 days of 1,000 mg/day of intravenous methylprednisolone infusion, she recovered rapidly.