A Confused Child

Children presenting to the emergency department with an acutely altered mental state require a thoughtful systematic approach to accurately identify the underlying disease process. We present a case of anti–N-methyl-D-aspartate receptor encephalitis that initially presented to our emergency department with acute confusion. With increasing recognition of this form of encephalitis, emergency physicians will benefit from understanding the salient neuropsychiatric features, disease progression, diagnostic options, management, and prognostic outcome of these patients.