INTRODUCTION:

Autoimmune encephalitis is caused by antineuronal immune mechanisms, its clinical presentation is heterogeneous, clinical and paraclinical criteria guide the approach, however, the challenge occurs when there are no detectable autoantibodies in serum or cerebrospinal fluid.

METHODOLOGY:

We report four cases that highlight the variability of clinical manifestations, which in the absence of antibodies (finally negative in three of the cases) were treated with immunotherapy with good response.

CONCLUSION:

In places where antibody measurement is not available expeditiously, or despite it being negative, given clinical suspicion, supported by CSF studies, magnetic resonance imaging and electroencephalographic recording, it is suggested to start early immunotherapy, usually resulting in the reversibility of the neurological disorder.

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