Abstract
A wide variety of movement disorders, often in combination, can be observed in children with anti-NMDAR encephalitis. A case of a 8 year old boy presenting as movement disorder, faciobrachial movements and seizures was diagnosed as NMDA encephalitis 3 years ago. CSF and serum NMDA antibodies were positive early in the course and early diagnosis could be made. The child deteriorated in spite of IVIGand methylprednisolone, needing ICU care and recovered gradually in 3-4 weeks after addition of Azathioprine. Prednisolone tapering doses and Azathioprine were continued as maintenance therapy and is still ongoing after three years There was gradual speech deterioration with loss of speech and the child developed a complex movement disorder, having multiple movement types, difficult to classify into the standard classification of movement disorders. The movements wax and wane with therapy but have not completely responded to maintenance Azathiprine and low dose steroids even after 3 years of therapy suggesting long term affection and disability due to complex movement disorders in NMDA encephalitis.
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