Violence, malignant catatonia or anti-NMDA receptor encephalitis: a case report

We present the case of a 25-year-old woman who initially presented after committing an assault resulting in serious injury. She exhibited recent onset psychiatric symptoms which were later followed by a rapid deterioration in her physical health. She was treated with electroconvulsive therapy on a medical intensive care unit for a presumptive diagnosis of malignant catatonia. A test for anti-NMDA receptor antibodies returned positive. She was treated with IV immunoglobulin (IVIg) and high dose steroids, then underwent a left ovarian cystectomy. She was subsequently treated on a psychiatric intensive care unit until discharge.