Seeing elephants and drinking water from a porcelain vase - A case of septin-7 antibody-associated encephalitis presenting as a severe disorganized psychosis

Identifying autoimmune encephalitis (AIE) in patients with predominant psychiatric symptoms poses a diagnostic challenge for psychiatrists and neurologists, especially when CSF and MRI findings are inconclusive. We report a case of septin-7 AIE presenting as steroid-responsive psychosis, whose definite diagnosis could only be made years after onset.