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We report the case of a 33\u2010year\u2010old woman who presented with a 10\u2010day history of acute behavioral and psychiatric symptoms initially suggestive of a primary psychiatric disorder. Although initial management was directed toward psychiatric illness, the clinical course evolved with fluctuating consciousness and abnormal involuntary movements, raising suspicion of an organic neurological process. Anti\u2010NMDAR antibodies were detected in cerebrospinal fluid, and imaging revealed a left ovarian teratoma. The patient received intravenous methylprednisolone, intravenous immunoglobulin, and surgical excision of the teratoma, resulting in significant clinical improvement without relapse during follow\u2010up and was managed through a coordinated interdisciplinary approach involving psychiatry, neurology, radiology, and gynecology. This case highlights the importance of recognizing early neurological red flags in apparent psychiatric presentations and emphasizes timely interdisciplinary intervention for optimal outcomes.<\/jats:p>","DOI":"10.1002\/ccr3.73426","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T06:22:46Z","timestamp":1788330166000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Delayed Recognition of Anti\u2010\n                    <scp>NMDAR<\/scp>\n                    Encephalitis Mimicking Primary Psychiatric Illness: A Case Report"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6159-9024","authenticated-orcid":false,"given":"Bhumika","family":"Ghimire","sequence":"first","affiliation":[{"name":"Institute of Medicine Tribhuvan University Teaching Hospital  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4813-5668","authenticated-orcid":false,"given":"Jagat","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Institute of Medicine Tribhuvan University Teaching Hospital  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saugat","family":"Niraula","sequence":"additional","affiliation":[{"name":"Institute of Medicine Tribhuvan University Teaching Hospital  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bibek","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Institute of Medicine Tribhuvan University Teaching Hospital  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun Batsa","family":"Lamsal","sequence":"additional","affiliation":[{"name":"Institute of Medicine Tribhuvan University Teaching Hospital  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5444-1088","authenticated-orcid":false,"given":"Shreeram","family":"Upadhyaya","sequence":"additional","affiliation":[{"name":"Institute of Medicine Tribhuvan University Teaching Hospital  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00401-9"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-024-03891-x"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJGM.S397429"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuint.2016.11.002"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.4314\/ssmj.v17i3.5"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-016-4050-9"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-020-05645-9"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70253-2"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medcli.2017.10.015"},{"key":"e_1_2_12_11_1","first-page":"235","volume-title":"Advances in Pharmacology","year":"2018"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70224-2"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1590\/2237-6089-2014-0036"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2010.09.012"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v10.i16.5196"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awq113"},{"issue":"8","key":"e_1_2_12_17_1","first-page":"584","article-title":"Autoimmune Encephalitis: Current Knowledge on Subtypes","volume":"19","author":"Nissen M. 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