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Research Article: Clinical characteristics and outcomes of anti-NMDA receptor-dominant autoimmune encephalitis

Date Published: 2026-05-26

Abstract:
Autoimmune encephalitis (AE) is a multifaceted neuroinflammatory condition characterized by a diverse array of neuropsychiatric symptoms and varying degrees of functional recovery. A retrospective cohort study conducted at a tertiary care institution analyzed 150 individuals diagnosed with AE from January 2017 to December 2023. The diagnosis of AE was made based on the subacute onset of neuropsychiatric symptoms that were compatible with neuronal autoantibody detection and/or distinctive EEG or MRI findings. Analysis was done on clinical, radiological, electrophysiological, and serological data. Clinical outcomes were assessed using the modified Rankin Scale (mRS) at the final follow-up appointment, with a score of ?3 indicating poor outcome. Multivariate logistic regression was employed to identify independent predictors of a poor prognosis. The average age of the cohort was 34.0?±?7.7 years, with 63 (42.0%) testing positive for anti-NMDA receptor antibodies. The most prevalent clinical manifestations included mental disorders 103 (68.7%), cognitive impairment 102 (68.0%), and seizures 89 (59.3%). EEG abnormalities 95 (63.3%) were more frequent than MRI abnormalities 57 (38.0%). Poor outcomes were observed in 45 (30.0%) of patients. Multivariate analysis identified four independent predictors of poor outcomes: mechanical ventilation (OR 10.72, 95% CI: 2.97-38.70, p <?0.001), presence of a tumor (OR 8.42, 95% CI: 2.07-34.24, p =?0.003), impaired consciousness (GCS < 8) (OR 4.05, 95% CI: 1.26-13.07, p =?0.019), and increasing age (OR 1.43, 95% CI: 1.26-1.63, p <?0.001). These results should be interpreted within this antibody distribution due to the prevalence of anti-NMDAR patients and the lack of thorough antibody stratification. In conclusion, advanced age, underlying malignancy, mechanical ventilation, and severe consciousness impairment are significant independent factors associated with poor functional recovery in autoimmune encephalitis.

Introduction:
Autoimmune encephalitis (AE) is a multifaceted neuroinflammatory condition characterized by a diverse array of neuropsychiatric symptoms and varying degrees of functional recovery.

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