What are the treatments for autoimmune encephalitis?

The treatment of autoimmune encephalitis must follow certain principles and methods. The current treatment for autoimmune encephalitis mainly involves intravenous injection of immunoglobulin, or steroid hormones, as well as the use of some B-cell group drugs.

1. Because autoimmune encephalitis is relatively rare , there are currently no randomized trials on treatment, and different syndromes and different antibody-related encephalitis respond differently to treatment. Current treatment is based mainly on case reports and expert consensus, with recommended first-line treatment options being intravenous immunoglobulin, high-dose corticosteroids, plasma exchange, or a combination of these. In cases where first-line treatment is ineffective, some drugs that affect B cell populations, such as rituximab, cyclophosphamide, and mycophenolate mofetil, can be considered.

2. Specifically , for LGI1 antibody-mediated limbic encephalitis, combined intravenous immunoglobulin and high-dose corticosteroids may be superior to steroid treatment alone. For anti-NMDA receptor encephalitis, studies have found that the efficacy of second-line treatment is more ideal. Treatment strategies for a disease may evolve over time and with experience.

3. Once the patient is discharged from the hospital, multidisciplinary care is recommended, including rehabilitation therapy, speech training, neuropsychiatric and neuroimmunological follow-up, and annual monitoring of malignancies.