ReviewAdvanced science (Weinheim, Baden-Wurttemberg, Germany)2026
Autoimmune Encephalitis in Acute Care-Pathology, Diagnosis, and Management.
Review in Advanced science (Weinheim, Baden-Wurttemberg, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
10 authors.
Funding
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Abstract
Autoimmune encephalitis (AE) is characterized by immune-mediated inflammation of the brain parenchyma, presenting with various neurological syndromes, including but not limited to seizures, altered consciousness, neuropsychiatric symptoms, and movement disorders. A significant proportion of patients with AE develop life-threatening complications that require hospital and potentially ICU admission. These patients present unique diagnostic and therapeutic challenges, presenting with a range of neurological emergencies such as refractory status epilepticus, severe dysautonomia, coma, and respiratory failure. Diagnosis relies on a combination of clinical criteria, detection of autoantibodies in serum and cerebrospinal fluid, neuroimaging, and electroencephalography, though antibody-negative AE poses considerable diagnostic difficulty. Management is centered on prompt initiation of first-line immunotherapies (corticosteroids, plasma exchange, and intravenous immunoglobulin therapy) and escalation to second-line or emerging targeted therapies (e.g., rituximab, cyclophosphamide, IL-6 inhibitors, proteasome inhibitors) in refractory cases, alongside aggressive supportive care for neurological and systemic complications. The prognosis is variable and influenced by factors such as the specific autoantibody, the timeliness of treatment, and the severity of complications. Long-term sequelae, including cognitive and psychiatric impairments, are common among survivors. This review provides a synthesis of current knowledge on AE in acute and intensive care. Given these diagnostic challenges and the potential for severe symptom presentation, the authors believe that this review is an essential addition to the discourse. This review covers pathophysiology, epidemiology, clinical manifestations, diagnostic approaches, immunotherapeutic strategies, management of critical complications, syndrome-specific considerations, prognostication, intensive care unit-related complications, and future research priorities to support optimal care.
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