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Anti-NMDAR – Second-Line — SCE Neurology MCQ

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ModerateCNS InfectionsAnti-NMDAR – Second-LineSCE Neurology

Anti-NMDAR encephalitis with tumour removed and first-line immunotherapy. Plateaued at 4 weeks. Next step?

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Correct answer: D — Escalate to second-line immunotherapy (rituximab/cyclophosphamide)

Requires second-line if insufficient response in 2–4 weeks. Recovery can take months. Up to 80% achieve good outcomes. A: More treatment needed. C: Inpatient required. D: Not infective. E: Treatment escalation priority.

Reference: ABN AE Guidelines; Dalmau et al.