Earlier treatment of NMDAR antibody encephalitis in children results in a better outcome.

The natural history of NMDA receptor (NMDAR) antibody encephalitis in adults and children is altered by treatment with immunosuppressive therapy or tumor removal.1 In adult cohorts, early initiation of immunotherapy appears to be beneficial.1,2 In the largest series to date, Titulaer et al.1 demonstrated that earlier treatment was associated with a modified Rankin Scale (mRS) score of 2 or less in a cohort of 501 adults and children (univariate analysis p5 0.009, multivariable analysis p, 0.0001).Multivariable analysis on 177 children within the cohort showed that earlier treatment was associated with an mRS score of 2 or less, although this did not reach statistical significance (p 5 0.067).1 An mRS score of 2 indicates slight disability and that the patient is unable to carry out all previous activities.