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

Area of Science:

• Neurology
• Critical Care Medicine

Background:

• New-Onset Refractory Status Epilepticus (NORSE) literature is limited, with management often based on case reports and expert opinion.
• This study retrospectively reviews seven NORSE cases managed over five years to contribute to existing data.

Observation:

• Patients presented with status epilepticus following prodromal symptoms like fever and headache.
• Initial imaging and CSF analysis were abnormal in some cases.
• Treatment involved prolonged use of anesthetic agents to achieve burst suppression, leading to extended ICU and hospital stays.

Findings:

• The mean age of patients was 43.5 years, with three females.
• One patient required 102 days of therapeutic burst suppression and 214 days of thiopentone.
• Mean ICU and hospital stays were 88 and 113.8 days, respectively.

Implications:

• Managing NORSE is complex and necessitates multiple anesthetic treatments.
• Prolonged intensive care unit and hospital stays are common.
• Despite challenges, favorable patient outcomes are possible with effective management strategies.