Afghanistan Comprehensive Specialization Exam Practice Questions - Afghanistan Comprehensive Specialization Completion Exam (Takhasus) Exam

A 23-year-old woman is brought to the hospital by her family due to dramatic behavioral changes, visual hallucinations, and acute persecutory delusions that developed over two weeks. Over the subsequent 5 days in the inpatient psychiatric unit, she developed refractory generalized tonic-clonic seizures, progressive mutism, prominent orofacial and lingual dyskinesias (lip-smacking and tongue protrusion), fluctuating hyperpyrexia, blood pressure instability, and sinus tachycardia. Brain MRI with gadolinium is normal. Routine CSF analysis reveals mild lymphocytic pleocytosis (22 WBCs/uL) with normal protein and glucose. Serum and CSF testing confirm high-titer antibodies against the GluN1 subunit of the NMDA receptor. Pelvic MRI reveals a 4.5 cm cystic and solid right adnexal mass. What is the fundamental two-pronged therapeutic strategy required for optimal long-term neurological recovery?