We report a case of organic personality changes with mood symptoms in a patient who had two previous episodes of Anti-NMDA receptor encephalitis.

We report a single case report of a 28-year-old Indian lady who presented to our psychiatry unit with labile affect and disruptive behaviour with progressive changes in her personality over a three year period. She had a previous history of two episodes of Non Paraneoplastic Anti-NMDA encephalitis at the neurological institute with neuropsychiatric manifestations and was receiving immunosuppressive drugs.

Patient presented with labile affect, erratic behaviour, poor anger control and a bout of physical aggression and damage to property prior to hospitalisation. She required atypical antipsychotics to manage her behaviour to start with but later responded well to sodium valproate. Her mood and behaviour gradually improved albeit subtle residual personality changes.

This case report highlights the importance of recognising and managing psychiatric sequale following an episode of Anti-NMDA encephalitis. More follow up studies are required to understand the clinical presentation of patients following the encephalitis.