Explaining suspected autoimmune encephalitis to parents — CASC communication station

Open. Introduce role, acknowledge fear and anger. “I can hear how frightening this looks, and you are right to ask hard questions.” [1]

Explain the illness model. “We are worried this may not be ordinary first-episode psychosis alone. Some people develop an immune condition — autoimmune encephalitis, classically anti-NMDA receptor encephalitis — where antibodies disrupt brain receptors. It can start with psychiatric symptoms, then speech problems and abnormal movements. It is a medical brain condition that psychiatry and neurology manage together.” [4][2]

Why tests. “A normal MRI does not rule this out. A lumbar puncture looks at inflammation and allows the best antibody tests from spinal fluid as well as blood. EEG looks at brain electrical activity. In young women we also carefully check for an ovarian teratoma — a growth that can trigger the immune attack and should be removed if present.” [3][2]

Treatment. “If this is likely autoimmune encephalitis, treatment is immunotherapy — often high-dose steroids, immunoglobulin infusions, and sometimes plasma exchange — not more antipsychotic as the main cure. Some people need further immune medicines. Many improve with early treatment, though recovery can take months.” [2][3]

About antipsychotics. “Psychiatric medicines were used to keep her safe from distress and risk. They are not the cause of classic autoimmune dyskinesias in this pattern, and they are not enough on their own. We will use the lowest necessary symptomatic medicines while treating the immune cause.” [1]

Close. Summarise, invite questions, offer written information, introduce neurology contact, document consent/capacity pathway if she cannot decide. Avoid inventing statute numbers; state least-restrictive legal principles under local law if emergency treatment is required. [1][3]