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

  • Kanterpersad Ramcharan
  • Nadeem Hosein
  • Joel David Teelucksingh
  • Fidel Rampersad
  • Surujpal Teelucksingh


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.