19 subjects were included, 12 females and with mean age of 68 (SD 8.77) years old. The most frequent presenting symptoms were cognitive/behavioral issues (15/19), headache (9/19), focal neurologic deficits (8/19) and seizure (4/19). Every patient was treated with steroids. 13/19 were started on steroid sparing agents, 6 on cyclophosphamide (CYC) and 7 on mycophenolate (MYC). Of the 11/19 patients that had recurrence of symptoms, 2 were on steroid sparing agents (2 vs 9, p = 0.31). Escalation of therapy with a second- and third-line agent was used on 5/19 patients. 2/19 patients had age < 60 years-old and both had multiple recurrences. Due to contra-indication to MYC, one of them was treated with RTX without success. 13/19 subjects reported headache alleviation and recovered cognitive function, 7/19 had either less frequent seizure episodes, or complete resolution of seizures, and 5/19 had improved focal motor deficits. 

We had too small of a sample to discuss the effectiveness of different agents and long-term use of steroid sparing agent was associated with lower recurrence rate but it was not statistically significant. Limitations of our study include small sample, retrospective design, selection bias (patients were seen at the neuroimmunology clinic at a tertiary center).