Narrative review links myasthenia gravis and autoimmune encephalitis risk

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Frontiers in Medicine Published April 24, 2026 Medically reviewed April 24, 2026 DOI ↗ By Dr. Ji-eun Park, MD · Brain, Mind & Pain

Key Takeaway

Consider the reported association between myasthenia gravis and autoimmune encephalitis when evaluating patients.

This narrative review explores the relationship between myasthenia gravis and autoimmune encephalitis, drawing on epidemiological data and multiple single case reports. The authors illustrate an increased risk for autoimmune encephalitis in patients with myasthenia gravis. The review does not provide pooled effect sizes, as it is not a meta-analysis.

The authors discuss treatment approaches for both conditions. For myasthenia gravis, they state that active treatment with immunosuppression should follow updated and generally accepted guidelines. For autoimmune encephalitis, they suggest considering high corticosteroid doses, intravenous immunoglobulin, plasma exchange, rituximab, and FcRn-blockers.

Key limitations include the narrative nature of the review and the absence of a systematic search or formal quality assessment. The authors do not report a study population, sample size, or specific statistical results. The evidence base is primarily illustrative rather than quantitative.

Practice relevance is limited to the authors' synthesized recommendations. Clinicians should be aware of the potential association but recognize the lack of robust trial-level data. The suggested treatments should be considered in the context of individual patient assessment and established guidelines.

Study Details

Study typeSystematic review

EvidenceLevel 1

PublishedApr 2026

View Original Abstract ↓

ObjectiveThis review aims to provide updated information about myasthenia gravis (MG) complicated with autoimmune encephalitis.BackgroundMG and autoimmune encephalitis are both antibody-mediated disorders with a need for active and individually adapted immunosuppressive treatment. The two disorders can co-exist. This represents therapeutic and diagnostic challenges but may help in elucidating disease mechanisms and risk factors.MethodsA literature search combined the words “myasthenia gravis,” “autoimmune encephalitis,” and further combined each specific antibody associated with autoimmune encephalitis and “myasthenia gravis.”ResultsEpidemiological data and multiple single case reports illustrate the increased risk for autoimmune encephalitis in MG. The target antigens for the antibodies in both MG and autoimmune encephalitis vary among patients. Clinical manifestations, choice of therapy, and prognosis depend on antibody pattern. MG should be treated actively with immunosuppression according to updated and generally accepted guidelines. For treatment of autoimmune encephalitis, high corticosteroid doses, intravenous immunoglobulin (IVIg), plasma exchange, and rituximab should be considered. FcRn-blockers represent an additional option.ConclusionMG and autoimmune encephalitis have overlapping pathogenesis and similar preferred drug therapies. This comorbidity represents a therapeutic challenge, and often with the need of high-dose immunosuppressive combination therapy. New and targeted therapies are applied in some MG patients, and such therapies have relevance also for autoimmune encephalitis.