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KMID : 1201420200130010065
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Journal of Neurocritical Care
2020 Volume.13 No. 1 p.65 ~ p.68
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Favorable clinical course after early-intensive immunotherapy for new-onset refractory status epilepticus
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Kim Hyun-Sung
Kim Ji-Young
Hwang Bo-Jin
Woo Kyoung-Nam
Park Min-Gyu
Park Kyung-Pil
Ahn Sung-Ho
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Abstract
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Background: New-onset refractory status epilepticus (NORSE) refers to the newly established concept of a disease characterized by refractory status epilepticus without an identifiable etiology. Recent reports have indicated the importance of immunotherapy for NORSE.
Case Report: A 37-year-old man with no past history of epilepsy was admitted for a presenting complaint of confusion. He was treated with acyclovir and anti-epileptic drug (AED) for presumed herpes encephalitis. However, he developed generalized tonic-clonic seizures on day 6 of admission that worsened despite treatment with multiple AEDs. NORSE was considered to be a probable diagnosis and immunotherapy with methylprednisolone and immunoglobulin was scheduled. However, persistent seizure activity was observed on the electroencephalogram after the completion of initial immunotherapy. Subsequently, rituximab was administered for 4 weeks. He eventually regained consciousness and was able to resume social activity.
Conclusion: Our patient exhibited a favorable outcome with early-intensive immunotherapy and subsequent rituximab treatment for NORSE.
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KEYWORD
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New-onset refractory status epilepticus, Immunotherapy, Rituximab
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