Encephalopathy as the presenting symptom of Hashimoto's thyroiditis

In recent years, encephalopathy has increasingly been recognized as a compl ication of Hashimoto's thyroiditis. It can begin abruptly as a stroke-like event, acute seizures, or confusion, or as an insidious decline in cognitiv e function. Most reported cases have been on adult patients, although this encephalopathy does affect children as well. This form of encephalopathy sh ould be considered in the differential diagnosis of children and adults wit h unexplained neurologic deterioration. We describe the case of a child in whom acute encephalopathy was the presenting symptom of Hashimoto's thyroid itis.