Anti NMDAR autoimmune encephalitis: treatment

Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .

Anti NMDAR autoimmune encephalitis: treatment. Methlyprednisolone, Intravenous immunoglobulins (IVIg). Fully referenced neurology checklist.

First line immunotherapy

  • Methlyprednisolone
  • Intravenous immunoglobulins (IVIg)
  • Plasma exchange

Second line immunotherapy

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Investigational treatments

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Surgery

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Possible markers of treatment response

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References

  1. Gastaldi M, Thouin A, Vincent A. Antibody-mediated autoimmune encephalopathies and immunotherapies. Neurotherapeutics 2016; 13:147-162.
  2. Seery N, Wesselingh R, Beech P, et al. Rituximab use for relapse prevention in anti-NMDAR antibody-mediated encephalitis: a multicenter cohort study. Neurol Neuroimmunol Neuroinflamm 2025; 12:e200395.
  3. Braakman HM, Moers-Hornikx VM, Arts BM, Hupperts RM, Nicolai J. Pearls & Oy-sters: Electroconvulsive therapy in anti-NMDA receptor encephalitis. Neurology 2010; 75:e44-46. 
  4. Scheibe F, Prüss H, Mengel AM, et al. Bortezomib for treatment of therapy-refractory anti-NMDA receptor encephalitis. Neurology 2017; 88:366-370.
  5. Behrendt V, Krogias C, Reinacher-Schick A, Gold R, Kleiter I. Bortezomib treatment for patients with anti-N-Methyl-D-Aspartase receptor encephalitis. JAMA Neurol 2016; 73:1251-1253.
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