橋本氏腦病變(Hashimoto’s encephalopathy)為橋本氏甲狀腺炎相關的罕見併發症，特徵為亞急性意識程度的混亂、癲癇、及肌陣攣。橋本氏腦病變是屬於免疫調節的疾病，若命名為「對類固醇有反應並與自體免疫甲狀腺炎相關之腦病變」 (Steroid-responsive encephalopathy associated with autoimmune thyroiditis , SREAT)則較為恰當。臨床上高度懷疑橋本氏腦病變很重要，因為疾病快速被診斷與治療時通常會有較佳的預後，若延遲診斷，可預期的結果就是恢復較不完全，尤其在長期未治療的情形下約有25%病患會有殘餘認知損害的情形。
報導個案為有精神分裂症的病人，她有瞻妄、緊張症而且注意力無法持續的症狀，而且情緒的轉換相當的快而且具有戲劇性，之後藉著實驗室的檢查結果診斷此病人為橋本氏腦病變造成的情緒疾病，在prednisolone的治療之後，病人的情況開始改善而且穩定。

Hashimoto’s encephalopathy (HE) is an uncommon syndrome associated with Hashimoto’s thyroiditis (HT). HE is most often characterized by a subacute onset of confusion with altered level of consiousness, seizures, and myoclnus. The bulk of evidence suggests that HE is an autoimmune disorder and is not due to  thyroid disease. Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT) is a more appropriate designation for this disorder. Therefore, it remains important to maintain a high clinical suspicion for HE since it is readily treatable condition that carries a good prognosis. While a delay to diagnosis and therefore treatment might be expected to be associated with less  complete  recovery,    residual  cognitive  impairment  occurs  in  about  25%  of  patients  with long-standing untreated disease.
We reported a clinical case of patient with schizophrenia (suspect schizoaffective disorder R/O organic brain syndrome). She was delirium, catatonia and attention can not be sustain and the course was fluctuation, so check her lab data to sure the patient was mood disorder due to HE. After prednisolone treatment, the patient’s condition was stable.