We describe an infant with a recent history of HSV encephalitis leading to generalized choreiform movements,who was positive for anti-N methyl-D-aspartate receptor antibodies.

Case report obtained from a pediatric patient referred to University of Kentucky.

This pediatric case serves as an evidence in proving HSV infection as one of the triggers for autoimmune encephalitis. Movement disorders in infants are difficult to diagnose, overlapping symptoms from seizures or cerebral palsy can make it further difficult. Relapsing symptoms post herpes simplex virus encephalitis should raise a high clinical suspicion of anti-NMDA receptor encephalitis and clinicians should be cautious as this condition can often be misdiagnosed in infants. Current treatment options are limited to immunotherapy and there is an unmet need for more research in pediatric population to improve the diagnosis and treatment.