Hemiataxia: A Novel Presentation of Anti-NMDA ReceptorAntibody Mediated Encephalitis in an Adolescent

Anti-NMDA receptor antibody associated encephalitis as a cause of new-onset neuropsychiatric manifestations in children andadults can represent a significant diagnostic challenge for clinicians. Clinical signs often include encephalopathy, new-onsetpsychosis, and movement phenomenon. Although orofacial dyskinesias were initially identified as a characteristic movementphenomenon in this type of encephalitis, an expanded range of abnormalities has recently been reported, including isolated ataxia.We report a case of isolated hemiataxia in a young adult with mild initial psychiatric manifestations. A personal and family historyof preceding neuropsychiatric symptoms produced diagnostic confusion and resulted in a significant diagnostic and therapeuticdelay. Our case confirms the unilateral movement manifestations that have been emphasized in recent reports. Additionally, itconfirms the need for involvement of neurologic as well as psychiatric services in the evaluation of such cases and emphasizes theimportance of the neurologic examination in presentations with an initial psychiatric predominance.