Gary Álvarez Bravo ^1* Giuseppe Guglielmini ² Ana Quiroga Varela ³ Almudena Boix Lago ² Ariadna Gifreu Fraixinó ² Daniele Urso ⁴ Giancarlo Logroscino ⁴ Lluís Ramió-Torrentà ³

• ¹ Neurodegeneration and Neuroinflammation group Unitat de Neuroimmunologia i Esclerosi Múltiple Territorial Girona, Departamento de Neurologia, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain
• ² Departamento de Neurologia, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain
• ³ Neurodegeneration and Neuroinflammation group Unitat de Neuroimmunologia i Esclerosi Múltiple Territorial Girona, Institute of Biomedical Research of Girona, Girona, Catalonia, Spain
• ⁴ Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari 'Aldo Moro', "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy. Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, United Kingdom; Parkinson's Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London SE5 9RS, United Kingdom, University of Bari Aldo Moro, Bari, Italy

Autoimmune encephalitides (AE) are a heterogeneous group of immune-mediated disorders with subacute onset that affect the central, peripheral and autonomic nervous systems.(1) Due to this multifocal involvement, an integrative system of assessment is imperative. Tools that accurately measure the severity and predict the risk of disability are still lacking in the approach of AE. AE are caused by different types of antibodies that share some clinical characteristics but also differs in their pathophysiological mechanisms and presumably in their prognosis.(2) It is crucial to identify some patients at risk of disability in order to individualized therapies that improve their functional outcomes.(3) We propose the Assessment of clinical prognosis in autoimmune encephalitis Girona Score (ACPE-Gi score) to evaluate the severity of AE at diagnosis or after relapses and predict the risk of disability at 3-months. The main goal of this scale is to carry out prompt therapeutic interventions that modify the clinical course based on early and precise detection of the risk of poor functional outcomes.Items such as:seizures, memory dysfunction, psychiatric symptoms, consciousness, language problems, movement disorders, ataxia, brainstem dysfunction, pyramidal/sensory dysfunctions, neuroimaging, autonomic symptoms, risk of cancer association according to the type of antibodies, and recurrences were considered for developing the scale. Unlike other clinical scales we have scored the neuroimaging, autonomic function, risk of cancer association and recurrences since we consider these items as important characteristics for the comprehensive clinical evaluation. The ACPE-Gi score is the first score that assesses most of clinical domains reported in the pathogenesis of AE.