• Epileptic Disord · Sep 2011

    Case Reports

    Non-convulsive status epilepticus of frontal origin as the first manifestation of Hashimoto's encephalopathy.

    • Laura Mirandola, Giulia Monti, Giada Giovannini, Matteo Pugnaghi, Alessandra Ariatti, Silvia Scacchetti, Paolo Nichelli, and Stefano Meletti.
    • Department of Neurosciences, University of Modena and Reggio Emilia, Modena, Italy.
    • Epileptic Disord. 2011 Sep 1; 13 (3): 253-8.

    AbstractHashimoto's encephalopathy is an often misdiagnosed, life threatening, condition which improves promptly with steroid therapy. Since clinical manifestations are heterogeneous and non-specific, the diagnosis is often difficult. Several case reports of Hashimoto's encephalopathy presenting with partial or generalised seizures are described, but only a few have focused on status epilepticus as the first clinical manifestation. We report two patients presenting with repetitive and prolonged seizures characterised by progressive reduction in contact and reactivity associated with frontal/diffuse polyspike-and-wave activities. This condition, which can be interpreted as a form of non-convulsive status epilepticus (NCSE) of frontal origin, was refractory to antiepileptic drugs but responded promptly to high doses of intravenous steroid treatment. In cases of unexplained encephalopathy with EEG documentation of NCSE, the early recognition and treatment of Hashimoto's encephalopathy may lead to a favourable prognosis. [Published with video sequences].

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