Clinical symptoms of catatonia, including excessive motor activity, agitation, aggression, negativism, and mutism, presented at various times for various durations throughout the illness course. A "benzodiazepine challenge test," proposed as a diagnostic assessment tool and a known beneficial treatment in catatonia, resulted in decreased irritability and marginally improved sleep but did not have the immediate and marked effect that would have warranted continued administration at higher doses and more frequent intervals. Because the patient did experience some benefit, 1 mg of lorazepam every 8 hours was continued for a brief period. Much remains to be learned about the symptomatic management of catatonia and other psychiatric manifestations associated with autoimmune encephalitis. Cases such as the one presented here are often protracted, with a number of interventions during the treatment course, making it difficult to establish the effectiveness of any one treatment. Other contributing factors may include the natural course of the illness, the potential for relapse, and evidence that suggests that complete recovery is achieved only with resolution of the underlying immune-mediated process.