{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T21:26:31Z","timestamp":1783113991900,"version":"3.54.6"},"reference-count":101,"publisher":"Wiley","issue":"37","license":[{"start":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T00:00:00Z","timestamp":1774742400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T00:00:00Z","timestamp":1774742400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["advanced.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Advanced Science"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Autoimmune encephalitis (AE) is characterized by immune\u2010mediated 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\u2010threatening 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\u2010negative AE poses considerable diagnostic difficulty. Management is centered on prompt initiation of first\u2010line immunotherapies (corticosteroids, plasma exchange, and intravenous immunoglobulin therapy) and escalation to second\u2010line or emerging targeted therapies (e.g., rituximab, cyclophosphamide, IL\u20106 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\u2010term 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\u2010specific considerations, prognostication, intensive care unit\u2010related complications, and future research priorities to support optimal care.<\/jats:p>","DOI":"10.1002\/advs.202519049","type":"journal-article","created":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T17:24:13Z","timestamp":1774805053000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Autoimmune Encephalitis in Acute Care\u2014Pathology, Diagnosis, and Management"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7934-4134","authenticated-orcid":false,"given":"Suneesh","family":"Thilak","sequence":"first","affiliation":[{"name":"Department of Anaesthesia Critical Care and Acute Care Royal Wolverhampton NHS Trust  Wolverhampton United\u00a0Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9118-5160","authenticated-orcid":false,"given":"David","family":"Okoh","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Critical Care and Acute Care Royal Wolverhampton NHS Trust  Wolverhampton United\u00a0Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0607-3190","authenticated-orcid":false,"given":"William","family":"Scotton","sequence":"additional","affiliation":[{"name":"Department of Neurology Royal Wolverhampton NHS Trust  Wolverhampton United\u00a0Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4362-1208","authenticated-orcid":false,"given":"Shanika","family":"Samarasekera","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospitals Birmingham NHS Foundation Trust Birmingham United\u00a0Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikram","family":"Patil","sequence":"additional","affiliation":[{"name":"Department of Radiology JSS Medical College JSS AHER  Mysuru India"},{"name":"JSS AHER \u2013 Wolverhampton Centre For Future Health and Policy Innovation  Mysuru India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5967-3619","authenticated-orcid":false,"given":"Suresh","family":"Renukappa","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Critical Care and Acute Care Royal Wolverhampton NHS Trust  Wolverhampton United\u00a0Kingdom"},{"name":"JSS AHER \u2013 Wolverhampton Centre For Future Health and Policy Innovation  Mysuru India"},{"name":"Faculty of Science and Engineering University of Wolverhampton  Wolverhampton United\u00a0Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4103-2896","authenticated-orcid":false,"given":"Andrew","family":"Macduff","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Critical Care and Acute Care Royal Wolverhampton NHS Trust  Wolverhampton United\u00a0Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5266-128X","authenticated-orcid":false,"given":"Subashini","family":"Suresh","sequence":"additional","affiliation":[{"name":"JSS AHER \u2013 Wolverhampton Centre For Future Health and Policy Innovation  Mysuru India"},{"name":"Faculty of Science and Engineering University of Wolverhampton  Wolverhampton United\u00a0Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6845-5894","authenticated-orcid":false,"given":"Rajeev","family":"Krishnadas","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Cambridge  Cambridge United\u00a0Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4125-8804","authenticated-orcid":false,"given":"Tonny","family":"Veenith","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Critical Care and Acute Care Royal Wolverhampton NHS Trust  Wolverhampton United\u00a0Kingdom"},{"name":"JSS AHER \u2013 Wolverhampton Centre For Future Health and Policy Innovation  Mysuru India"},{"name":"Research Institute of Healthcare Sciences (RIHS) University of Wolverhampton  Wolverhampton United\u00a0Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,29]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A5086"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000042472"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010024\u201005233\u20102"},{"key":"e_1_2_5_5_1","first-page":"249","volume-title":"Current Clinical Neurology","author":"Diaz\u2010Arias L. A.","year":"2020"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028\u2010016\u20100370\u20107"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-015-0196-8"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.12974"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1708712"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells13010015"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2025.106566"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.3988\/jcn.2016.12.1.1"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awq213"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.22307"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.916111"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.92.15_supplement.P2.2-005"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2017.00835"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000006990"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000891"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001940"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000514"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.652864"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.47162\/RJME.64.4.03"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1017\/9781108696722"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(15)00401\u20109"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000200306"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(13)70282\u20105"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1017\/cjn.2024.16"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000200151"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.21050"},{"key":"e_1_2_5_31_1","first-page":"838","article-title":"Anti\u2010Ma2\u2010Associated Encephalitis and Paraneoplastic Limbic Encephalitis","volume":"62","author":"Yamamoto T.","year":"2010","journal-title":"Brain Nerve"},{"key":"e_1_2_5_32_1","doi-asserted-by":"publisher","DOI":"10.17925\/ENR.2013.08.01.31"},{"key":"e_1_2_5_33_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000200353"},{"key":"e_1_2_5_34_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000485"},{"key":"e_1_2_5_35_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics10060356"},{"key":"e_1_2_5_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/WNP.0000000000000654"},{"key":"e_1_2_5_37_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182698cd8"},{"key":"e_1_2_5_38_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2019.00804"},{"key":"e_1_2_5_39_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000200170"},{"key":"e_1_2_5_40_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000200148"},{"key":"e_1_2_5_41_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2022.4251"},{"key":"e_1_2_5_42_1","doi-asserted-by":"publisher","DOI":"10.1017\/cjn.2024.321"},{"key":"e_1_2_5_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(23)00083\u20102"},{"key":"e_1_2_5_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00281\u2010024\u201001034\u20105"},{"key":"e_1_2_5_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2006.11.006"},{"key":"e_1_2_5_46_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard\u20102022\u2010223335"},{"key":"e_1_2_5_47_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10875\u2010007\u20109088\u20109"},{"key":"e_1_2_5_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.51540"},{"key":"e_1_2_5_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2024.103710"},{"key":"e_1_2_5_50_1","doi-asserted-by":"publisher","DOI":"10.1385\/CRIAI:29:3:173"},{"key":"e_1_2_5_51_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.51313"},{"key":"e_1_2_5_52_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp\u20102020\u2010325300"},{"key":"e_1_2_5_53_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp\u20102021\u2010327302"},{"key":"e_1_2_5_54_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010022\u201006793\u2010z"},{"key":"e_1_2_5_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2025.e41747"},{"key":"e_1_2_5_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2021.120042"},{"key":"e_1_2_5_57_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40263\u2010022\u201000943\u2010z"},{"key":"e_1_2_5_58_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072\u2010019\u201003930\u20103"},{"key":"e_1_2_5_59_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000001088"},{"key":"e_1_2_5_60_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000200395"},{"key":"e_1_2_5_61_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41420\u2010025\u201002459\u2010z"},{"key":"e_1_2_5_62_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737175.2025.2483925"},{"key":"e_1_2_5_63_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0000000000001139"},{"key":"e_1_2_5_64_1","doi-asserted-by":"publisher","DOI":"10.1177\/1535759720928269"},{"key":"e_1_2_5_65_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.624202"},{"key":"e_1_2_5_66_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17391"},{"key":"e_1_2_5_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurol.2023.12.001"},{"key":"e_1_2_5_68_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000205089"},{"key":"e_1_2_5_69_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.70280"},{"key":"e_1_2_5_70_1","doi-asserted-by":"publisher","DOI":"10.1159\/000541965"},{"key":"e_1_2_5_71_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.52260"},{"key":"e_1_2_5_72_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010025\u201005726\u20108"},{"key":"e_1_2_5_73_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1233-2190"},{"key":"e_1_2_5_74_1","doi-asserted-by":"publisher","DOI":"10.1007\/s44337-025-00205-z"},{"key":"e_1_2_5_75_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201603\u20100507OC"},{"key":"e_1_2_5_76_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.674368"},{"key":"e_1_2_5_77_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415\u2010023\u201011881\u20101"},{"key":"e_1_2_5_78_1","doi-asserted-by":"publisher","DOI":"10.4103\/aian.AIAN_574_20"},{"key":"e_1_2_5_79_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.27177"},{"key":"e_1_2_5_80_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000200123"},{"key":"e_1_2_5_81_1","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000000814"},{"key":"e_1_2_5_82_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000200131"},{"key":"e_1_2_5_83_1","doi-asserted-by":"publisher","DOI":"10.1080\/01616412.2025.2495932"},{"key":"e_1_2_5_84_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001682"},{"key":"e_1_2_5_85_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415\u2010018\u20109153\u20108"},{"key":"e_1_2_5_86_1","article-title":"Autoimmune Encephalitis in the ICU: Serological Spectrum, Clinical Courses, Complications and Outcomes (P4.046)","volume":"84","author":"McKeon A.","year":"2015","journal-title":"Neurology"},{"key":"e_1_2_5_87_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000003796"},{"key":"e_1_2_5_88_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001907"},{"key":"e_1_2_5_89_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000212005"},{"key":"e_1_2_5_90_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000696"},{"key":"e_1_2_5_91_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2018.10.014"},{"key":"e_1_2_5_92_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.861988"},{"key":"e_1_2_5_93_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182a2cc6d"},{"key":"e_1_2_5_94_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072\u2010024\u201007642\u20101"},{"key":"e_1_2_5_95_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000200102"},{"key":"e_1_2_5_96_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000006783"},{"key":"e_1_2_5_97_1","doi-asserted-by":"publisher","DOI":"10.3988\/jcn.2023.0242"},{"key":"e_1_2_5_98_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000001033"},{"key":"e_1_2_5_99_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.69038"},{"key":"e_1_2_5_100_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13185416"},{"key":"e_1_2_5_101_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000208615"},{"key":"e_1_2_5_102_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1503099"}],"container-title":["Advanced Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/advanced.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/advs.202519049","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/advanced.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/advs.202519049","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/advanced.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/advs.202519049","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T21:10:23Z","timestamp":1783113023000},"score":1,"resource":{"primary":{"URL":"https:\/\/advanced.onlinelibrary.wiley.com\/doi\/10.1002\/advs.202519049"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,29]]},"references-count":101,"journal-issue":{"issue":"37","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/advs.202519049"],"URL":"https:\/\/doi.org\/10.1002\/advs.202519049","archive":["Portico"],"relation":{},"ISSN":["2198-3844","2198-3844"],"issn-type":[{"value":"2198-3844","type":"print"},{"value":"2198-3844","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,29]]},"assertion":[{"value":"2025-09-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e19049"}}