Anti-N-Methyl-D-Aspartate Receptor Encephalitis: A Potentially Treatable Cause of Neuropsychiatric Syndrome

A young adolescent girl with no history of psychiatric illness presented with acute onset of delusional ideas and behavioural changes that were followed by recurrent seizures, involuntary movement and oromotor dyskinesia. Anti-N-methyl-D-aspartate receptor (NMDAR) antibodies were present in the serum and she was successfully treated with immunotherapy. The presence of neurological features including convulsions, movement disorder and autonomic disturbance are important clues to the diagnosis of anti-NMDAR encephalitis in patients who initially present with acute psychiatric symptoms. Early diagnosis and treatment is warranted as aggressive immunotherapy improves clinical outcome.