[Undetected Hashimoto encephalopathy--a diagnostic challenge in child psychiatry and child neurology].

The literature is reviewed. Hashimoto encephalopathy is a steroid-responsive encephalopathy associated with Hashimoto thyroiditis (SREHT). The incidence of SREHT in childhood is underestimated. Two subtypes have been described. The diffuse progressive type is associated with insidious onset and progressive impairment of mental status, such as confusion, somnolence, and psychosis. The vasculitic type is characterized by acute stroke-like episodes associated with focal neurologic features and seizures. Hashimoto encephalopathy (SREHT) is a clinical condition with elevated thyroid antibody titers encompassing persistent or relapsing seizures, myoclonus, focal neurologic deficits and neuropsychiatric disorders such as psychosis, delusions and hallucinations, and affective disorders. By far, the vast majority of reports on paediatric and adult patients describe a dramatic clinical response to either methylprednisolone pulse therapy or daily oral prednisone or prednisolone.