Anti-N-methyl-D-aspartate receptor antibody encephalitis: Post-acute neuropsychological consequences and rehabilitation in adolescence

We present a case of a teenager (Laura) with anti-NMDA receptor encephalitis who was seen post-acute illness within an interdisciplinary community paediatric neuropsychological rehabilitation centre. Following a review of the key literature summarising this condition, illness trajectory, and outcomes, we describe Laura's clinical presentation and the prolonged route to appropriate services and treatment. We describe our initial and follow-up assessment in order to track her recovery and put in place community-based rehabilitation. We also discuss the dilemma clinicians face in timing the administration of standard neuropsychological assessment in individuals where presentation, outcome, and recovery, including valid test batteries for repeated measurement, are less clearly defined. We include a review of the broader confounds to recovery, consideration of repeated and long-term neuropsychological assessment to facilitate a resumption of normal life including school and community relationships. Finally, we discuss the need to consider secondary consequences, especially in the developmental context of this rare condition; including lingering illness, trauma, and the impact of interruptions to key periods of development. In sharing this case we hope to raise awareness of this condition to aid rapid identification and treatment, including the need for longer-term support where needed.