Treatment of Anti-NMDA-receptor encephalitis in children under 18 with standard (non-severe) disease

This protocol covers first-line management of NMDA receptor antibody encephalitis specifically in paediatric patients aged under 18 whose presentation meets the criteria for standard disease severity — that is, none of the severe safety and function markers are present.

Clinical scenario

Children (age <18 years) with NMDA receptor antibody encephalitis at standard, non-severe disease severity. Severe disease is defined by markers affecting safety and function; when none of those criteria are met, this protocol applies.

Treatment approach (overview)

First-line immunotherapy — anchored by an initial course of intravenous corticosteroids — is the foundation of management, with an optional intravenous immunoglobulin add-on also available within the protocol. The full sequence of agents, alternative options, extended taper, and decision criteria are detailed in the complete regimen.

Treatment goal

The primary target is significant clinical improvement in function, assessed approximately one week after initiating corticosteroids. Failure to achieve meaningful functional gains signals a need to reassess the treatment plan.

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References

DOI: 10.1212/NXI.0000000000001052 View source ↗