ArticleChinese medical journal2018
Utility and Safety of Intrathecal Methotrexate Treatment in Severe Anti-N-methyl-D-aspartate Receptor Encephalitis: A Pilot Study.
Article in Chinese medical journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 38 citations in OpenAlex.
- Anti-Inflammatory and Antioxidant Strategies in Epilepsy: From Molecular Mechanisms to Threshold Management.International journal of molecular sciences · 2026Review
- The Treatment of Antibody-Mediated Encephalitis: Current, Future Therapies, Unmet Need and Patient Management.Advances in therapy · 2026Review
- Coexistence of anti-GluK2 and anti-LGI1 antibodies in a patient with autoimmune encephalitis: a rare case report and literature review.BMC neurology · 2026Review
- Intrathecal treatment of Anti-N-Methyl-D-Aspartate receptor encephalitis: a promising approach for refractory cases.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Review
- IgG-NR2B-A Potentially Valuable Biomarker in the Management of Refractory Anti-NMDAR Encephalitis.International journal of molecular sciences · 2025Article
- Methotrexate and the Risk of Dementia: A Two-Sample Mendelian Randomization Study.Neurology and therapy · 2024Article
- Anti-N-methyl-D-aspartate receptor type autoimmune encephalitis with severe pneumonia: a case report.World journal of emergency medicine · 2024Article
- Controversies in immunotherapy for anti-NMDA receptor encephalitis: a scoping review with a proposal of operational definitions.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2023Article
- Autoimmune Encephalitis-A Multifaceted Pathology.Biomedicines · 2023Article
- Effectiveness of intra-thecal methotrexate in refractory Anti-N-methyl-d-aspartate receptor encephalitis.BMC neurology · 2023Review
- Autoimmune Encephalitis: A Physician's Guide to the Clinical Spectrum Diagnosis and Management.Brain sciences · 2022Review
- Recent research on immunotherapy for anti-N-methyl-D-aspartate receptor encephalitis.Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2022Review
- Anti-inflammatory and immune-mediated therapy for a case of febrile infection-related epilepsy syndrome with rapid recurrence.Clinical case reports · 2022Article
- Cytokine dynamics and targeted immunotherapies in autoimmune encephalitis.Brain communications · 2022Review
- International Consensus Recommendations for the Treatment of Pediatric NMDAR Antibody Encephalitis.Neurology(R) neuroimmunology & neuroinflammation · 2021Article
- Anti-N-methyl-d-aspartate receptor encephalitis: A primer for acute care healthcare professionals.Journal of the Intensive Care Society · 2021Article
- Longitudinal measurement of cerebrospinal fluid neurofilament light in anti-N-methyl-D-aspartate receptor encephalitis.European journal of neurology · 2021Article
- Intrathecal dexamethasone therapy for febrile infection-related epilepsy syndrome.Annals of clinical and translational neurology · 2021Article
- Anti-NMDAR encephalitis: A single-center, longitudinal study in China.Neurology(R) neuroimmunology & neuroinflammation · 2020Article
- Intrathecal Rituximab as a Rescue Therapy in Refractory Pure CSF Positive, Non-Teratomatous Type Anti-NMDAR Encephalitis.Annals of Indian Academy of NeurologyArticle
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAnti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a treatable autoimmune neurologic syndrome that occurs with or without tumor association. However, some severe cases are refractory to systemic immunotherapy. This pilot study aimed to evaluate the utility and safety of intrathecal methotrexate injection for severe patients with anti-NMDAR encephalitis who did not respond to first-line immunotherapy.
methodsIntrathecal injections with methotrexate and dexamethasone were performed weekly in four legible patients within consecutive 4 weeks. Cerebrospinal fluid (CSF) was collected at baseline and each time of intrathecal injection for identification of anti-NMDAR antibody titers.
resultsSignificant clinical improvement was observed in three patients associated with a stepwise decrease of CSF anti-NMDAR antibody titers (maximum: 1/320 to minimum: 1/10). After 2 months of follow-up, they were able to follow simple commands and had appropriate interactions with people (modified Rankin scale [mRS] of 0-2). At 12 months of follow-up, they all had returned to most activities of daily life (mRS of 0), and no relapses were reported. One patient showed no clinical improvement and died of neurologic complications.
conclusionsIntrathecal treatment may be a potentially useful supplementary therapy in severely affected patients with anti-NMDAR encephalitis. Further large cohort study and animal experiment may help us elaborate the utility of intrathecal injection of methotrexate and its mechanism of action.
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