A young adult male patient presented with subacute onset, rapidly progressive cognitive impairment and refractory seizures and was diagnosed as definite anti N-methyl D-aspartate receptor (anti-NMDAR) antibody encephalitis as per criteria by Graus et al. (2016), following detection of culprit autoantibodies in serum.1 MRI of brain revealed bilateral T2-weighted image (T2WI)/fluid-attenuated inversion recovery (FLAIR) claustrum hyperintensities (figure 1). Previously, in a cohort of 34 patients,2 presenting with new-onset refractory epilepsy, 4 out of 34 patients showed bilateral claustrum FLAIR hyperintensities on MRI imaging, none …