What are the recommended first-line treatments for a patient diagnosed with autoimmune encephalitis in primary care?

For a patient diagnosed with autoimmune encephalitis, first-line treatments are not initiated in primary care. Autoimmune encephalitis is a complex neurological condition that requires urgent specialist assessment and management, typically in a hospital setting, due to the nature of the required immunotherapeutic interventions (Nosadini et al., 2021; Dutra et al., 2024). The primary care role involves prompt recognition of potential symptoms and urgent referral to secondary or tertiary care for diagnosis and treatment.

In specialist care, the recommended first-line immunotherapeutic treatments for autoimmune encephalitis commonly include high-dose corticosteroids, intravenous immunoglobulins (IVIg), or plasma exchange (PLEX) (Nosadini et al., 2021; Dutra et al., 2024). For example, in N-Methyl-d-Aspartate Receptor Antibody Encephalitis (NMDAR-AE), corticosteroids, IVIg, and PLEX are established first-line immunotherapeutic options (Nosadini et al., 2021). The specific choice and combination of these treatments are determined by specialists based on the type of autoimmune encephalitis and the patient's clinical presentation (Dutra et al., 2024).