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. 2018 Jan 9;6(2):e537. doi: 10.1212/NXI.0000000000000537

Figure. Time course of the patient's diagnostics and treatment.

Figure

The patient initially presented to an outside hospital for altered behavior and was discharged home with a psychiatric diagnosis. When she continued to deteriorate, she presented to our hospital with breath-holding spells, encephalopathy, and dysautonomia. The patient completed a 5-day course of IVMP and IVIG for presumed anti-NMDAR encephalitis. She was initially started on broad-spectrum antibiotics and acyclovir, which were discontinued after a negative HSV PCR. Once her CSF returned positive for VZV, she was started on a 21-day course of acyclovir. HSV = herpes simplex virus; IVIG = intravenous immunoglobulin; IVMP = intravenous methylprednisolone; LP = lumbar puncture; VZV = varicella zoster virus.