RT Journal Article SR Electronic T1 Bortezomib for anti-NMDAR encephalitis following daclizumab treatment in a patient with multiple sclerosis JF BMJ Neurology Open JO BMJ Neurol Open FD BMJ Publishing Group Ltd SP e000096 DO 10.1136/bmjno-2020-000096 VO 3 IS 1 A1 Kushan Karunaratne A1 Dariush Ahrabian A1 Bernadette Monaghan A1 Tom Campion A1 Tarek Yousry A1 Michael P Lunn A1 Michael S Zandi A1 Robin S Howard A1 Dimitri M Kullmann A1 Jennifer Spillane A1 Matthew Walker A1 Jeremy Chataway YR 2021 UL http://neurologyopen.bmj.com/content/3/1/e000096.abstract AB Background Daclizumab is an anti-CD25 monoclonal antibody developed for the treatment of relapsing remitting multiple sclerosis, which was withdrawn worldwide in March 2018, due to emerging serious immune-mediated systemic andcentral nervous system adverse events. We report a case of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis occurring 14 weeks after stopping daclizumab, which responded to the proteasome inhibitor bortezomib.Methods Following lack of effective clinical response to first line (corticosteroid, plasma exchange, intravenous immunoglobulin) and second line (rituximab) treatments, bortezomib therapy was commenced. The patient received six cycles of bortezomib treatment.Results Clinical improvement was noted 4 weeks after the first of six cycles of bortezomib and the patient experienced sustained clinical improvement.Conclusion Our case provides further class IV evidence of the use of bortezomib therapy for treatment refractory anti-NMDAR encephalitis.All data relevant to the study are included in the article.