IntroductionAnti-N-methyl-D-aspartate (Anti-NMDAR) encephalitis in children has become a formidable, yet important, disease for intensive care physicians to diagnose, manage clinical manifestations and ultimately treat. Anti-NMDAR encephalitis was initially described in 2005 in four women with ovarian teratomas, presenting with seizures, acute psychiatric disorders, cognitive deficits, decreased sensoriality, autonomic instability and hypoventilation [1]. Dalmau et al. in 2007, they diagnosed these women and 8 others after demonstrating NMDAR-specific autoantibodies; namely a neuronal cell surface protein that was found to be the NR1 subunit of the receptor [2]. Since the first reported cases and the discovery of anti-NMDAR encephalitis, this autoimmune disease has surpassed all viral etiologies and has been recognized as the second most common entity after acute demyelinating encephalitis (ADEM) [2, 3]. Similarly, the estimated mortality in a series for anti-NMDAR encephalitis is 4% with median mortality after 3 and a half months of symptoms [4]. Although there have been more than 600 cases reported in the literature, further considerations for critical care physicians have been lacking [5-11]. In this review of the current literature, we discuss the pathophysiology, diagnosis, clinical manifestations and intensive care management of anti-NMDAR encephalitis with clinical recommendations drawn from our center's experience. DiscussionEpidemiology, clinical manifestations, diagnosis and treatmentAnti-NMDAR encephalitis affects both men and women. , although its incidence is higher in women (75% of all cases) [8, 12-16]. Although it was initially described as a paraneoplastic disease with 58% of patients showing signs of...... middle of article ......nsAnti-NMDAR encephalitis is a commonly encountered diagnosis in intensive care in adults and children. A multidisciplinary approach in a patient- and family-centered model helps patients and their families cope with a long recovery. Intensive care physicians play an instrumental role in coordinating the care of these patients. Additionally, a careful understanding of the clinical features of the disease, diagnosis, and therapeutic interventions is paramount to patient prognosis. Finally, early rehabilitation after careful consideration of tracheostomy and gastrostomy placement can further improve functional outcomes. Future studies comparing ICU management of pharmacological approaches and non-pharmacological interventions of autonomic dysfunction, movement disorders, and cardiac arrhythmias will be important for improving patient care and outcomes...