The ages ranged from 12 to 24. Among these cases, there were two females, both adults. The other two were pediatric males. Presenting clinical syndromes varied significantly, including acute and subacute encephalopathy, subacute progressive psychosis, and subacute meningismus without encephalopathy. 3 cases also had fever, abdominal pain, nausea and emesis at onset of neurologic symptoms. No cases had a clear prodromal illness. CSF studies showed lymphocytic pleocytosis in 3 cases and protein elevation in all cases. Titers of anti-GFAP IgG in CSF ranged from 1:8 to 1:64. MRI of brain and spine showed stigmata of elevated ICP in 2 cases, leptomeningeal enhancement in 1 case, parenchymal enhancement in 1 case, and was normal in one case. EEG revealed subclinical seizures in 1 case and was normal in others. All cases were treated with immunotherapy, including intravenous methylprednisolone in all cases, plasmapheresis in 3 cases, and intravenous immunoglobulin in 1 case. 2 cases had worsening of symptoms requiring additional treatment. Maintenance immunotherapy with rituximab was started in 3 cases, one of which also received cyclophosphamide. 2 of 4 cases had significant symptomatic improvement with treatment, with the pediatric cases demonstrating minimal improvement. There were no mortalities.