Anti-NMDA receptor (NMDAR) encephalitis is a autoimmune disorder with prominent psychiatric symptoms. Patients usually present with acute behavioural change, psychosis, catatonic symptoms, memory deficits, seizures, dyskinesia, and autonomic instability.
We describe a 28 yrs old female patient who had previous 2 brief episodes of psychosis and has now again presented with psychosis but then clinical condition gradually worsened and she developed dyskinesia, catatonic symptoms and seizures. Though her routine blood work, brain imaging was normal, a confirmative diagnosis of NMDAR encephalitis was made by positive CSF studies. Patient was treated with methylprednisolone and plasmapheresis to which she showed response. This case illustrates the importance of considering NMDA R encephalitis as a differential diagnosis especially in young female with neuropsychiatric symptoms and progressive disturbance of consciousness, and associated involuntary movements, since prognosis depends on early recognition and treatment.