Objective: To identify incidence and clinical features of SREAT patients in MSMC.

Background: SREAT patients could present with encephalopathy with various neurological abnormalities, including behavioral change, psychosis, mood disturbance, seizure, stroke-like episodes, tremors, chorea, myoclonus, and ataxia. Serology studies of antithyroid peroxidase (anti-TPO) and anti-thyroglobulin antibodies (anti-TG) play a role in establishing a diagnosis.

Method: There are two research methodology processes: retrospective and prospective process. For the retrospective study, we retrieved the hospital database from EMR and Binary Record systems between January 2020 and June 2024, while the prospective study was conducted between July 2024 and March 2025 after receiving ethical approval. N is 255 cases. Inclusion criteria for suspected SREAT cases are concordant with the modified criteria of possible autoimmune encephalitis: (1) age between 18-80 years, (2) at least one of the following clinical features: seizure, confusion, cognitive impairment, mood disorders, ischemic stroke symptoms, movement disorders, and ataxia or gait abnormality. Baseline characteristics are genders, age, occupation, educational levels, and current locations. The onset duration, neurology and psychiatry problems, and both previous and existing systemic illnesses are identified and recorded, as well as blood and CSF investigations, EEG, and brain CT/MRI.

Results: The cumulative incidence of SREAT is 4.47 cases/100 persons (95% CI 2.75-6.82). For anti-TPO/anti-TG positive cases, the cumulative incidence of SREAT is 25.32 cases/100 persons (95% CI 16.20-36.36). The mean age of the non-SREAT group is 64.23 (SD 18.12) years, while the SREAT group is 63.60 (SD 13.78) years (p=0.899). The mean disease duration of the non-SREAT group is 163.49 days (SD 387.72), and the SREAT group is 298.35 days (SD 636.43) (p=0.031). Chorea is an abnormal movement that significantly associated with SREAT (p<0.001).  Tremor is also significant (p=0.007).Other significant clinical features of SREAT are cognitive impairment (p=0.010) and abnormal behavior (p=0.024).

Conclusion: The cumulative incidence indicated that SREAT is rare but can be detected in patients who develop subacute encephalitis/encephalopathy. Abnormal behavior, cognitive impairment, abnormal movements, chorea, and tremors are statistically significant features of SREAT.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/incidence-and-movement-disorders-associated-with-steroid-responsive-encephalopathy-associated-with-autoimmune-thyroiditis-sreat-in-the-princess-maha-chakri-sirindhorn-medical-center-msmc/