Medical case narrative
A 16-year-old in Morocco — first-episode psychosis that wasn't
What happened
A 16-year-old girl in Casablanca, Morocco, arrived with a first episode of psychosis and was started on risperidone, up to 2 mg a day.
What it looked like
New psychosis in a teenager. Then her body joined in: she developed features that made her team suspect neuroleptic malignant syndrome, a dangerous reaction to antipsychotic medication, with a creatine kinase (CK) of 1,482 IU/l.
What the labs found
Her spinal fluid tested positive for anti-NMDA receptor antibodies — autoimmune encephalitis, not a primary psychotic illness.
What changed
She received intravenous immunoglobulin (IVIG), 2 g/kg over five days. Her psychiatric symptoms resolved within a month, with complete remission by two months.
The test that told the story
CSF anti-NMDA receptor antibody testing.
Sources: Published case report, PubMed Central / EJCRIM (the same paper in two hosts).