Treatment of Anti-NMDA-Receptor Encephalitis in Autoimmune Encephalitis Meeting Diagnostic Criteria, Age 3 or Older
This first-line protocol applies to patients aged 3 years or older who have Anti-NMDA-receptor encephalitis in the context of autoimmune encephalitis that meets defined clinical and laboratory diagnostic criteria, and who do not have severe autonomic instability.
Clinical Scenario
The patient is aged 3 years or older with autoimmune encephalitis satisfying 4 of 6 clinical criteria and at least 1 of 2 abnormal laboratory criteria. Severe autonomic instability is not present. This combination of findings defines the specific population for whom this protocol is indicated.
Treatment Approach — Partial Overview
First-line management involves a course of high-dose intravenous corticosteroid therapy in combination with intravenous immunoglobulin.
References
DOI: 10.1212/CPJ.0000000000200218
- Patient ≥ 3 years of age with 3 of 6 clinical criteria*
- Patient has 4 of 6 clinical criteria* and 1 of 2 abnormal laboratory criteria**
- Severe autonomic instability?
- IV methylprednisone 30mg/kg (1 gram maximum) for 3-7 days and IVIG 2g/kg