scholarly journals New Onset Refractory Status Epilepticus as an Unusual Presentation of a Suspected Organophosphate Poisoning

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Shahan Waheed ◽  
Amber Sabeen ◽  
Nadeem Ullah Khan
Keyword(s):  
Status Epilepticus ◽  
Intravenous Infusion ◽  
Refractory Status Epilepticus ◽  
Young Female ◽  
University Hospital ◽  
Organophosphate Poisoning ◽  
Anesthetic Agents ◽  
Refractory Status ◽  
History Of ◽  
New Onset

New onset refractory status epilepticus (NORSE) is a new entity in medical literature. It has different infectious and noninfectious etiologies showing a devastating impact onto the clinical outcome of patients. Therapy with anaesthetic and antiepileptic agents often fails to improve the condition, unless the primary cause is rectified. Here is presented the case of a young female with a history of depression who after a recent bereavement came to the Emergency Department of Aga Khan University Hospital with complaints of drowsiness that lasted for few hours. Though she had no history of organophosphate poisoning, her physical examination and further investigations were suggestive of the diagnosis. During her hospital stay, she developed refractory status epilepticus. Her seizures did not respond to standard antiepileptic and intravenous anesthetic agents and subsided only after intravenous infusion of atropine for a few days. Organophosphate poisoning is a very common presentation in the developing world and the associated status epilepticus poses a devastating problem for emergency physicians. In patients with suspected organophosphate poisoning with favoring clinical exam findings, the continuation of atropine intravenous infusion can be a safe option to abate seizures.

scholarly journals Vagus Nerve Stimulation (VNS) in Super Refractory New Onset Refractory Status Epilepticus (NORSE)

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Mohankumar Kurukumbi ◽  
James Leiphart ◽  
Anam Asif ◽  
Jing Wang
Keyword(s):  
Status Epilepticus ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Refractory Epilepsy ◽  
Refractory Status Epilepticus ◽  
Refractory Status ◽  
History Of ◽  
Electrographic Seizures ◽  
New Onset

The treatment protocol of status epilepticus has many associated toxicities so there is interest in alternate nonmedicinal therapies for managing New Onset Refractory Status Epilepticus (NORSE) patients. Vagus nerve stimulation (VNS) is an FDA-approved therapy for refractory epilepsy that has been shown to decrease the frequency and severity of seizures. We present the case of a patient with new-onset refractory status epilepticus (NORSE) whose seizures were successfully treated with vagus nerve stimulation. A 25-year-old male with no history of epilepsy or other neurological disorders presented with altered mental status and generalized tonic-clonic seizures following a two-week history of an upper respiratory tract infection. Lumbar puncture showed neutrophilic pleocytosis, and he was treated for bacterial and viral meningoencephalitis. In spite of treatment, his seizures began increasing in frequency. On day three, the patient entered status epilepticus (SE) refractory to intensive pharmacotherapy with maximal doses of valproate, levetiracetam, and propofol. On day four, SE remained refractory, so pentobarbital was introduced with targeted burst suppression pattern on electroencephalography (EEG). Patient continued to be refractory to these measures, so a vagus nerve stimulator (VNS) was implanted (day eight). Following VNS implantation, EEG demonstrated significant reduction of seizure activity and subsequent magnet swiping continued aborting electrographic seizures. No SE or electrographic seizures were reported for seventy-two hours, but few occasional discharges were reported. Seizures eventually recurred on day fourteen and the patient succumbed to his multiple comorbidities on day seventeen. Due to the efficacy of VNS in refractory epilepsy, there was interest in using it in refractory status epilepticus. Multiple case reports have described a benefit from implantation of VNS in the treatment of SE. The successful use of VNS to acutely terminate status epilepticus for seventy-two hours in this critically ill patient adds to current evidence that there is utility in using VNS for refractory status epilepticus.

scholarly journals Intravenous immunoglobulin response in new-onset refractory status epilepticus (NORSE) COVID-19 adult patients

2021 ◽  
Author(s):  
Paolo Manganotti ◽  
Giovanni Furlanis ◽  
Miloš Ajčević ◽  
Cristina Moras ◽  
Lucia Bonzi ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Intravenous Immunoglobulin ◽  
Case Series ◽  
Autoimmune Encephalitis ◽  
Refractory Status Epilepticus ◽  
Adult Patients ◽  
University Hospital ◽  
Paroxysmal Activity ◽  
Refractory Status ◽  
New Onset

AbstractNeurological manifestations may be common in COVID-19 patients. They may include several syndromes, such as a suggested autoimmune abnormal response, which may result in encephalitis and new-onset refractory status epilepticus (NORSE). Quickly recognizing such cases and starting the most appropriate therapy is mandatory due to the related rapid worsening and bad outcomes. This case series describes two adult patients admitted to the university hospital and positive to novel coronavirus 2019 (SARS-CoV-2) infection who developed drug-resistant status epilepticus. Both patients underwent early electroencephalography (EEG) assessment, which showed a pathological EEG pattern characterized by general slowing, rhythmic activity and continuous epileptic paroxysmal activity. A suspected autoimmune etiology, potentially triggered by SARS-CoV-2 infection, encouraged a rapid work-up for a possible autoimmune encephalitis diagnosis. Therapeutic approach included the administration of 0.4 g/kg intravenous immunoglobulin, which resulted in a complete resolution of seizures after 5 and after 10 days, respectively, without adverse effects and followed by a normalization of the EEG patterns.

scholarly journals How to Help Your Patients Enroll in the New-Onset Refractory Status Epilepticus (NORSE) and Febrile Infection-Related Epilepsy Syndrome (FIRES) Family Registry, and Other Rare Epilepsy Registries

2021 ◽  
pp. 153575972199832
Author(s):  
Karnig Kazazian ◽  
Marissa Kellogg ◽  
Nora Wong ◽  
Krista Eschbach ◽  
Raquel Farias Moeller ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Refractory Status Epilepticus ◽  
Epilepsy Syndrome ◽  
Neurologic Disorder ◽  
Mortality And Morbidity ◽  
Refractory Status ◽  
Rigorous Research ◽  
Active Epilepsy ◽  
New Onset

New-onset refractory status epilepticus (NORSE) is a rare clinical presentation of refractory status epilepticus (RSE) that occurs in people without active epilepsy or preexisting neurologic disorder. Febrile infection-related epilepsy syndrome (FIRES) is a subcategory of NORSE. New-onset refractory status epilepticus/FIRES are becoming increasingly recognized; however, information pertaining to disease course, clinical outcomes, and survivorship remains limited, and mortality and morbidity are variable, but often high. The objective of the NORSE/FIRES Family Registry is to (1) provide an easily accessible and internationally available multilingual registry into which survivors or NORSE/FIRES surrogates or family members of people affected by NORSE/FIRES or their physicians can enter data in a systematic and rigorous research study from anywhere in the world where internet is available; and (2) to examine past medical history, outcomes, and quality of life for people affected by NORSE/FIRES.

scholarly journals Resolution of cryptogenic new onset refractory status epilepticus with tocilizumab

2021 ◽  
Vol 15 ◽  
pp. 100431
Author(s):  
Jonathan P. Donnelly ◽  
Nidhi Kasatwar ◽  
Shaheryar Hafeez ◽  
Ali Seifi ◽  
Andrea Gilbert ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Refractory Status Epilepticus ◽  
Refractory Status ◽  
New Onset

scholarly journals New-onset super refractory status epilepticus: A case-series

Seizure ◽  
2020 ◽  
Vol 75 ◽  
pp. 174-184 ◽  
Author(s):  
Sidra Aurangzeb ◽  
Lara Prisco ◽  
Jane Adcock ◽  
Mahiri Speirs ◽  
Simon Raby ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Case Series ◽  
Refractory Status Epilepticus ◽  
Refractory Status ◽  
New Onset

New Onset Refractory Status Epilepticus (NORSE)

2009 ◽  
Vol 284 (1-2) ◽  
pp. 220 ◽  
Author(s):  
Rahul Rathakrishnan ◽  
Einar P. Wilder-Smith
Keyword(s):  
Status Epilepticus ◽  
Refractory Status Epilepticus ◽  
Refractory Status ◽  
New Onset

New-Onset Refractory Status Epilepticus (NORSE): The Queen Square Neuro-ICU experience

2021 ◽  
Vol 125 ◽  
pp. 108387
Author(s):  
Aidan Neligan ◽  
Bellami Kerin ◽  
Matthew C Walker ◽  
Sanjeev Rajakulendran
Keyword(s):  
Status Epilepticus ◽  
Refractory Status Epilepticus ◽  
Refractory Status ◽  
New Onset

A case of very prolonged new onset refractory status epilepticus (NORSE) with no evidence of autoimmune activation and a good neurological recovery

2020 ◽  
Vol 41 (10) ◽  
pp. 3003-3006 ◽  
Author(s):  
Monica Ferlisi ◽  
Elena Greco ◽  
Tiziano Zanoni ◽  
Monica Zamagni ◽  
Marilena Casartelli Liviero ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Refractory Status Epilepticus ◽  
Neurological Recovery ◽  
Refractory Status ◽  
New Onset
Sign in / Sign up

Export Citation Format

Share Document