Besides typical clinical features, hypothyroidism can present with neurological features like reversible cerebellar ataxia, dementia, peripheral neuropathy, coma, etc. We present a case of 40 year old female patient presented with complaints of symmetrical and progressive unsteadiness while walking, dysarthria for a period of two weeks. On examination scanning speech present, dysmetria on finger-nose test and heel-knee test, dysdiadokinesia present, tandem gait impaired .On evaluation CSF analysis was normal, MRI brain  plain and contrast was normal. TSH was 150 µIU/L, anti TPO antibodies were 684 IU/ml. She was diagnosed as autoimmune thyroid disease with hypothyroidism and was given levothyroxine supplementation. she improved symptomatically. Hypothyroidism should be considered in all cases of cerebellar ataxia as it is a potentially treatable and reversible cause of ataxia.

Keywords: Autoimmune thyroid disease, hypothyroidism, cerebellar ataxia.

1. Sandyk R. Cerebellar dysfunction in hypothyroidism. S Afr Med J. 1982;62 (14):468.
2. Barnard RO, Campbell MJ, McDonald WI. Pathological findings in a case of hypothyroidism with ataxia. J Neurol Neurosurg Psychiatry. 1971;34(6):755-60.
3. Quinn N, Barnard RO, Kelly RE. Cerebellar syndrome in myxoedema revisited: a published case with carcinomatosis and multiple system atrophy at necropsy. J Neurol Neurosurg Psychiatry. 1992;55(7):616-8.
4. Honnorat J, Trouillas P, Thivolet C, et al. Autoantibodies to glutamate decarboxylase in a patient with cerebellar cortical atrophy, peripheral neuropathy, and slow eye movements. Arch Neurol 1995; 52:462–8.
5. Selim M, Drachman DA. Ataxia associated with Hashimoto’s disease: progressive non-familial adult onset cerebellar degeneration with autoimmune thyroiditis. J Neurol Neurosurg Psychiatry. 2001;71(1):81-7.

Chintada Sruthikeerthi

Post Graduate, Department of General Medicine, Andhra Medical College