Autoimmune encephalitisis a cluster of closely associated diseases that share overlapping clinical symptoms, however, are ultimately distinguished by the precise antibody subtypes driving the main immune-mediated attack on different brain structures. Anti-N-methyl-D-aspartate (NMDA) receptor antibody-associated limbic encephalitis is the most common form of autoimmune encephalitis, primarily affecting young women under the age of 50. Patients affected present with a range of neuropsychiatric symptoms, including anxiety, hostility, psychosis as well as abnormal movements, speech dysfunction, memory deficits, seizures and altered levels of consciousness. We aim to discussa case of young lady with anti-NMDA-receptor-associated encephalitis presenting with subacute onset of polymorphic psychosis that within two months progressed into catatonia, seizures and coma. The patient had no previous psychiatric history and was initially treated with antipsychotics and electroconvulsive therapy. Our experience emphasises the definite diagnosis of anti-NMDA receptor associated encephalitis is not easy, especially in its early phases. This is because most patients initially present with psychiatric symptoms than neurological manifestation. Furthermore, immunological and laboratory testing are not easily accessible and where available, take a rather long time to determine the diagnosis. What is more, few psychiatrists consider the autoimmune nature of this neuropsychiatric syndrome. Therefore, psychiatrists should consider the possibility of anti-NMDA receptor associated encephalitis in young women under the age of 50 who present with characteristic neuropsychiatric symptoms.
