Anti-NMDAR encephalitis and MOGAD - Clinical and treatment insights

This letter responds to Yan et al.'s study on anti-NMDAR encephalitis combined with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), highlighting its valuable findings on clinical features, MRI lesion diversity, high relapse rates, and rituximab's efficacy in reducing recurrence. We emphasize limitations including reliance on the modified Rankin Scale, which overlooks cognitive and psychosocial impairments, advocating for comprehensive neuropsychological and quality-of-life assessments in future research. The absence of control groups limits comparison to isolated NMDARE or MOGAD cases. Additionally, we propose that the observed high cortical encephalitis rate may reflect additive rather than synergistic effects of both antibodies, given that cortical involvement is known in each condition independently. Further studies should clarify these mechanisms to improve understanding and management of this complex overlap syndrome.