Background Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a rare autoimmune disorder that may initially present with psychiatric symptoms, making its early recognition challenging. Case report We report a 24-year-old female presenting with acute psychosis, behavioral changes, and insomnia, initially treated as a primary psychiatric disorder. She later developed seizures, orofacial dyskinesia, and autonomic dysfunction. CSF analysis revealed strongly positive anti-NMDA receptor antibodies, and pelvic imaging identified a left ovarian teratoma. The tumor was surgically removed and followed by immunotherapy with corticosteroids and IVIG. She achieved complete recovery within six months. Conclusion Anti-NMDA receptor encephalitis is a rare but treatable diagnosis that clinicians should consider in young patients with atypical or rapidly progressive psychiatric symptoms. Early recognition leads to the early course of tumor removal and the initiation of immunotherapy, providing optimal outcomes.

Introduction: Sleep is essential for cognitive performance and psychological well-being. Medical students are particularly vulnerable to sleep disturbances due to academic stress and irregular schedules. Beta-blockers are increasingly used to alleviate anxiety and performance stress, with lipophilic agents such as propranolol affecting sleep. Evidence on the association of beta-blocker use with sleep disturbances among medical students in Jordan is limited. Objective: The aim of this study was to describe self-reported sleep characteristics among medical students in Jordan and report patterns related to beta-blocker use. Methods: A quantitative cross-sectional study was conducted among 697 undergraduate students from six public medical schools in Jordan over a one-month period. Data were collected using an anonymous online questionnaire on beta-blocker use and sleep characteristics. Associations were analyzed using chi-square tests, with a p < 0.05 considered significant. Results: Of 697 students, 23 (3.3%) were current and 11 (1.6%) were previous users of beta-blockers; 663 (95.1%) had never used them. Beta-blocker use was significantly associated with smoking status (p = 0.013) but not with academic level or caffeine consumption. In multivariable analysis, males had lower odds (OR = 0.4) of beta-blocker use compared with females. More than half of current users (56.5%) reported non-prescribed use, with propranolol (78.3%) being the most commonly used beta-blocker. Sleep-related disturbances were frequently reported among current users, including nocturnal awakenings (73.9%), nightmares or disturbing dreams (69.6%), morning fatigue (65.2%), difficulty waking (52.2%), and sleep-onset insomnia (39.1%), with about one-third reporting a decline in sleep quality. Conclusions: Beta-blocker use among medical students in Jordan is mostly non-prescribed and primarily for anxiety or exam stress. Users frequently reported sleep disturbances, highlighting the need for medical guidance to prevent adverse effects. These findings can inform local guidelines and raise awareness about the risks of unsupervised beta-blocker use among medical students, supporting safer practices and better overall well-being.