scholarly journals Higher mortality rate is associated with advanced age and periodic lateralized epileptiform discharges in patients with refractory status epilepticus

2013 ◽  
Vol 71 (3) ◽  
pp. 153-158 ◽  
Author(s):  
Paulo Breno Noronha Liberalesso ◽  
Eliana Garzon ◽  
Elza M.T. Yacubian ◽  
Américo C. Sakamoto
Keyword(s):  
Status Epilepticus ◽  
Mortality Rate ◽  
Clinical Data ◽  
Focal Epilepsy ◽  
Refractory Status Epilepticus ◽  
Advanced Age ◽  
Neurological Sequelae ◽  
Epileptiform Discharges ◽  
Refractory Status ◽  
Treatment Morbidity

ObjectiveTo evaluate clinical data, electroencephalogram, etiology, classification, treatment, morbidity, and mortality in acute refractory status epilepticus.MethodsFifteen patients, mean age of 41.3 years-old, six males, with refractory status epilepticus, were retrospectively studied. All of them were followed by serial electroencephalogram or continuous electroencephalographic monitoring.ResultsThe most common comorbidity was hypertension. Seven (46.7%) patients were diagnosed with previous symptomatic focal epilepsy. More than one etiology was identified in 40.0% of the cases. Status epilepticus partial complex was the most common (n=14, 93.3%), and discrete seizures were the most observed initial ictal pattern. Continuous intravenous midazolam was used in nine (60.0%) patients and continuous thiopental in three (20.0%). Nine (60.0%) participants died, one (6.6%) had neurological sequelae, and five (33.3%) presented no neurological sequelae.ConclusionsHigher mortality rate was associated with advanced age and periodic lateralized epileptiform discharges. Midazolam proved to be a safe drug. The refractory status epilepticus is related to high mortality.

scholarly journals Isoflurane in (Super-) Refractory Status Epilepticus: A Multicenter Evaluation

2021 ◽  
Author(s):  
Henning R. Stetefeld ◽  
Alexander Schaal ◽  
Franziska Scheibe ◽  
Julia Nichtweiß ◽  
Felix Lehmann ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Status Epilepticus ◽  
Side Effects ◽  
Magnetic Resonance ◽  
Refractory Status Epilepticus ◽  
Good Effect ◽  
Resonance Imaging ◽  
Epileptiform Discharges ◽  
Refractory Status ◽  
Isoflurane Treatment

Abstract Background We aimed to determine the association between seizure termination and side effects of isoflurane for the treatment of refractory status epilepticus (RSE) and super-refractory status epilepticus (SRSE) in neurointensive care units (neuro-ICUs). Methods This was a multicenter retrospective study of patients with RSE/SRSE treated with isoflurane for status epilepticus termination admitted to the neuro-ICUs of nine German university centers during 2011–2018. Results We identified 45 patients who received isoflurane for the treatment of RSE/SRSE. During isoflurane treatment, electroencephalograms showed no epileptiform discharges in 33 of 41 (80%) patients, and burst suppression pattern was achieved in 29 of 41 patients (71%). RSE/SRSE was finally terminated after treatment with isoflurane in 23 of 45 patients (51%) for the entire group and in 13 of 45 patients (29%) without additional therapy. Lengths of stay in the hospital and in the neuro-ICU were significantly extended in cases of ongoing status epilepticus under isoflurane treatment (p = 0.01 for length of stay in the hospital, p = 0.049 for length in the neuro-ICU). During isoflurane treatment, side effects were reported in 40 of 45 patients (89%) and mainly included hypotension (n = 40, 89%) and/or infection (n = 20, 44%). Whether side effects occurred did not affect the outcome at discharge. Of 22 patients with follow-up magnetic resonance imaging, 2 patients (9%) showed progressive magnetic resonance imaging alterations that were considered to be potentially associated with RSE/SRSE itself or with isoflurane therapy. Conclusions Isoflurane was associated with a good effect in stopping RSE/SRSE. Nevertheless, establishing remission remained difficult. Side effects were common but without effect on the outcome at discharge.

scholarly journals Autoimmune Encephalitis: An Unusual Presentation as Nonconvulsive Status Epilepticus

2019 ◽  
Vol 7 (01) ◽  
pp. 41-43
Author(s):  
Deepak Solanki ◽  
Saurabh Anand
Keyword(s):  
Status Epilepticus ◽  
Autoimmune Encephalitis ◽  
Refractory Status Epilepticus ◽  
Clinical Findings ◽  
Acute Onset ◽  
Prior History ◽  
Laboratory Findings ◽  
Epileptiform Discharges ◽  
Refractory Status ◽  
History Of

AbstractWhen refractory status epilepticus (RSE) occurs in an individual without any history of epilepsy and no immediate underlying etiology is found, it is referred to as new-onset refractory status epilepticus (NORSE). This clinical scenario may be notoriously difficult to treat and does not respond to initial medications. In cases of NORSE in which an etiology is found, antibody-mediated disorders are the most common cause. Autoimmune encephalitis refers to a diverse group of neuropsychiatric disorders and can present with an array of symptoms many of which make diagnosis difficult due to similarities in clinical, imaging, and laboratory findings with respect to other forms of autoimmune or infectious encephalitis. This case report highlights how a patient with acute-onset history, showing generalized periodic epileptiform discharges on electroencephalogram (EEG) but with no prior history of seizures, was eventually diagnosed as autoimmune encephalitis based on clinical findings, cerebrospinal fluid (CSF) reports, and EEG analysis.

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
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