Anti-NMDA Receptor Encephalitis in a Young Girl with Altered Behaviour and Abnormal Movements

Autoimmune encephalitis is a rare central nervous system disorder in which the patient presents with neuropsychiatric symptoms. We herein present a case of anti-NMDA receptor encephalitis in which the patient initially presented in the psychiatric department. A 14-year girl was brought with complains of irritability, altered behaviour, abnormal movements, self biting, and decreased sleep for the past 10 days. Her condition deteriorated during the admission and she became mute, immobile, and drowsy. Her baseline investigations and CT scan brain were normal. CPK was high and the CSF showed pleocytosis. Autoimmune encephalitis profile showed presence of antibodies against the NMDA receptors. Improvement in the symptoms was noted after treatment with steroids and plasmapharesis. This case report highlights the importance of multidisciplinary approach involving the neurologist, psychiatrist, and immunologist in accurately diagnosing and managing a rare neurological disorder presenting mainly with psychiatric symptoms.