Reversible splenial lesion in a patient with new-onset refractory status epilepticus (NORSE)

Area of Science:

• Neurology
• Neuroscience
• Emergency Medicine

Background:

• New-onset refractory status epilepticus (NORSE) is a critical neurological condition associated with significant morbidity and mortality.
• Early diagnosis and effective treatment are crucial for improving patient outcomes in NORSE.

Purpose of the Study:

• To report a case of NORSE presenting with a reversible splenial lesion.
• To evaluate the efficacy of a combined treatment approach including immunotherapy and targeted temperature management (TTM) for NORSE.

Main Methods:

• A 30-year-old male presented with refractory seizures following a febrile illness.
• Magnetic Resonance Imaging (MRI) revealed a reversible splenial lesion.
• The patient was treated with a combination of immunotherapy and TTM.

Main Results:

• The patient experienced refractory multifocal and generalized seizures despite standard anticonvulsant therapy.
• The combined treatment of immunotherapy and TTM led to a significant reduction in seizure frequency.
• The splenial lesion observed on MRI was reversible.

Conclusions:

• NORSE should be considered in the differential diagnosis of acute encephalopathy, even in the presence of reversible splenial lesions.
• Combination therapy with immunotherapy and TTM represents a promising treatment strategy for NORSE.