Prominent Bilateral Hand Tremor in Hashimoto's Encephalopathy: A Video Demonstration

Tremor Other Hyperkinet Mov (N Y). 2016 Oct 12:6:419. doi: 10.7916/D8PV6KJB. eCollection 2016.

Abstract

Background: Hashimoto's encephalopathy often presents with neuropsychiatric manifestations including seizures and movement disorders.

Case report: We describe a patient who presented with bilateral hand tremor and mild cognitive defects that fulfilled the criteria for a diagnosis of Hashimoto's encephalopathy. There was a rapid response to glucocorticoid therapy with relapse following treatment withdrawal.

Discussion: Recently published clinical criteria for the diagnosis of Hashimoto's encephalopathy include seizures, myoclonus, hallucinations, or stroke-like episodes but do not include tremor. Our case had mild cognitive dysfunction and a coarse tremor as the predominant clinical features, which probably represent mild disease.

Keywords: Hashimoto’s encephalopathy; Tremor; movement disorders; steroid‐responsive encephalopathy associated with autoimmune thyroiditis.