New onset refractory status epilepticus research: What is on the horizon?. (23rd April 2019)

• Record Type: Journal Article
• Authors: Gofton, Teneille E.; Gaspard, Nicolas; Hocker, Sara E.; Loddenkemper, Tobias; Hirsch, Lawrence J.
• Is Part Of: Neurology. Volume 92:Number 17(2019)
• Publication Date: 2019-04-23
• Subjects: Neurology -- Periodicals; Neurology -- Periodicals; Neurologie -- Périodiques; 616.8
• DOI: 10.1212/WNL.0000000000007322
• Languages: English
• ISSNs: 0028-3878

Abstract

Abstract : New-onset refractory status epilepticus (NORSE) is a clinical presentation, not a specific diagnosis, in a patient without active epilepsy or other preexisting relevant neurologic disorder, with new onset of refractory status epilepticus (RSE) that does not resolve after 2 or more rescue medications, without a clear acute or active structural, toxic, or metabolic cause. Febrile infection-related epilepsy syndrome is a subset of NORSE in which fever began at least 24 hours prior to the RSE. Both terms apply to all age groups. Until recently, NORSE was a poorly recognized entity without a consistent definition or approach to care. We review the current state of knowledge in NORSE and propose a roadmap for future collaborative research. Research investigating NORSE should prioritize the following 4 domains: (1) clinical features, etiology, and pathophysiology; (2) treatment; (3) adult and pediatric evaluation and management approaches; and (4) public advocacy, professional education, and family support. We consider international collaboration and multicenter research crucial in achieving these goals.