Presentation may include alteration of conscious level, seizures, tremor, myoclonus, ataxia, or multiple stroke
-like episodes. Psychiatric symptoms, including depression and psychosis, have also been reported .
Course of Hashimoto's encephalopathy may be relapsing/remitting or progressive, even evolving into dementia. Nonspecific imaging abnormalities may be present. Brain MRI findings may change abruptly and drastically.