Autoimmune encephalitis: Case

A previously well 13-year-old girl is brought to the emergency department after 10 days of agitation, insomnia, and auditory hallucinations. Over the last 48 hours she has had two generalised tonic-clonic seizures, repetitive grimacing and chewing movements, and episodes of shallow slow breathing. Her temperature is 37.4 degrees Celsius, her capillary glucose is 5.0 millimoles per litre, and her weight is 48 kilograms. She is obtunded. MRI brain is normal. CSF shows 45 lymphocytes per microlitre, protein 0.55 g per litre, and oligoclonal bands. Her serum antibody panel is pending.