P-568 - Acute psychotic disorder due to anti-NMDA-receptor encephalitis in a 19 year old female: a case report

Introduction Anti-NMDA-receptor encephalitis is a ttreatabel but potentially fatal syndrome that has been recently identified as a neuropsychiatric presentation. We describe the case of a 19 year old woman referred with an acute psychotic presentation that deteriorated to catatonia an other problems requiring intensive care. Objectives To review the presentation of anti-NMDA-receptor encephalitis and its implications in emergency psychiatry. Methods Case report and review of the literature. Results A 19 year old female university student was referred to an acute in-patient psychiatric unit following a 3–4 days history of delusional beliefs with fluctuating episodes of aggression and agitation. She was initially treated with oral quetiapine up to 600 mg daily but became catatonic after few days. She then deteriorated quickly developing hypoventilation and aspiration pneumonia that required admission to a medical intensice care unit and intubation. Anti-NMDA-encephalitis was diagnosed. Conclusions Anti-NMDA-receptor encephalitis is a syndrome that can present as an acute psychotic disorder before developing more organif symptoms. Awarenes of the disorder can potentially bring an earlier recognition and treatment and improve outcome. Implications in care models provision are discussed due to the severity of both physical and psychiatric symptoms.