•Anti-NMDA-receptor encephalitis is a paraneoplastic syndrome caused by teratomas.•The syndrome includes psychiatric symptoms followed by autonomic dysregulation.•Rapid diagnosis and removal of the tumor is essential for optimizing outcomes.•Following recovery, counsel on contraceptive options, particularly LARC methods.•If no tumor is identified initially, monitor for development of ovarian teratoma.
Keywords: Encephalitis; Paraneoplastic syndrome; Teratoma.