How would you manage a patient with LGI-1 encephalitis with faciobracial dystonic seizures who has not improved with 3 days of intravenous steroids?

I typically treat with five days of IV steroids. In patients with autoimmune encephalitis, including LGI-1, who do not improve after five days of IV steroids, I would then move to IVIG or plasmapheresis (depending on patient comorbidities, availability of plasmapheresis, and severity of symptoms). If the patient had prior relapses of LGI-1 encephalitis or did not improve after all the above immunotherapies, rituximab would be the next agent I would consider.