Spontaneous Resolution of Postpartum Hashimoto Encephalopathy with Levothyroxine Therapy Alone

ABSTRACT Objective: Hashimoto encephalopathy (HE) is an uncommon syndrome characterized by seizures, movement disorders, cognitive or neuropsychiatric symptoms associated with dysthyroidism, and elevated anti-thyroperoxidase antibodies. It is more prevalent in females and all age groups can be affected. While its pathophysiology remains unclear, it is commonly defined as a steroid-responsive condition. Rarely, HE manifests with cerebellar ataxia. Methods: We report the case of a 21-year-old female presenting with cerebellar HE after delivery spontaneously resolving without corticosteroid treatment. Results: This case adds to the limited data available on HE and challenges the common conception of HE as a steroid-responsive disease. Conclusion: While our case suggests that HE might spontaneously recover, it is too limited to be conclusive and further studies are needed to clearly define the mechanism, exacerbating factors, and treatment options. HE should be considered in patients with otherwise unexplained cerebellar ataxia. Abbreviations: HE Hashimoto encephalopathy; TPO Abs anti-thyroperoxidase antibodies