Objective: To probe into the efficacy and prognostic factors of first-line immunotherapy on anti-N-Methyl-D aspatate receptor encephalitis (NMDAR). Methods: Totally 63 children with anti-NMDAR admitted into Xi’an Children’s Hospital from Feb. 2012 to Feb. 2017 were extracted as the research objects. Glucocorticoid combined with intravenous immunoglobulin injection was used for treatment

the modified Rankin scale (mRS) score and recurrence of the patients were followed up after treatment. Univariate and Logistic regression were used to analyze the risk factors of mRS score and recurrence after treatment. Results: After treatment of two months by first-line immunotherapy

the mRS score was (1.52±0.71) points

and 12.98%(8/63) of the children relapsed after one year of follow-up. Univariate analysis showed that the mRS score was related to the age of children’s first onset

accompanied by involuntary exercise

peak mRS score

seizures and onset of treatment time (P<0.05)

recurrence was associated with the first onset accompanied by involuntary movement

peak mRS score and seizures (P<0.05). Logistic regression analysis showed that the risk factors for mRS score were peak mRS score

accompanied by involuntary movement

seizures

and onset of treatment time (P<0.05)

the risk factors for recurrence were peak mRS score and seizures (P<0.05). Conclusion: The first-line immunotherapy has singnificant effects of anti-NMDAR encephalitis. Peak mRS scores and seizures are important risk factors that affect the short-term efficacy and recurrence of children after treatment.