Abstracts

Rationale: Steroid Responsive Encephalopathy Associated with Autoimmune Thyroiditis (SREAT) is a rare and poorly understood neurological condition. Patients present with elevated serum levels of anti-thyroid peroxidase (anti-TPO) antibodies and intractable adult-onset epilepsy. These patients may benefit from steroid treatment. Methods: Seven patients in Comprehensive Epilepsy Clinic at London Health Sciences Centre were identified as having both elevated anti-TPO antibodies and medically intractable adult onset epilepsy. They were worked up and matched with seven controls with medically intractable adult onset epilepsy but no evidence of elevated anti-TPO antibodies. Results: Each group consisted of 5 females and 2 males. Average age in the anti-TPO group was 38 years versus 34 years in the control group with average age of onset being 33 years in the anti-TPO group versus 28 years for the controls. The patients in both groups were on an average taking 2 anti-eplieptic drugs (AEDs). Five of the anti-TPO patients suffered from other auto-immune conditions versus only one of the controls (p<0.05). Average serum Anti-TPO levels were 240 u/L in the anti-TPO group versus 13 u/L in the control group. Average serum Anti-Thyroglobulin levels were 1599 u/L in the anti-TPO group versus 144 u/L in the controls. Finally, average Thyroid Stimulating Hormone (TSH) levels in the anti-TPO group were 2.68 u/L versus 2.7 u/L in the control group. Steroid therapy was initiated in one of the patients from the anti-TPO group which resulted in a significant reduction in the number of her seizures.