Early immunotherapy in cryptogenic new onset refractory status epilepticus (NORSE), a case series

Abstract

To date, there are no clear guidelines for treatment of cryptogenic new onset refractory status epilepticus (NORSE) syndrome. Immunotherapy was effective for some patients, but the initiation time was often somewhat late. We experienced two cryptogenic NORSE syndrome patients with favorable outcomes with early immunotherapy. A 59 years old male patient and a 58 years old female patient visited our hospital in status epilepticus, who were later diagnosed as cryptogenic NORSE after full evaluation. Since seizures were not controlled by two or more antiepileptic drugs in both patients, immunotherapy began on the fifth day of hospitalization. There was improvement on EEG and clinical symptoms, one or two days after initiation of immunotherapy. Early diagnosis of NORSE and early immunotherapy may result in favorable outcome.