A case of cryptogenic new-onset refractory status epilepticus (NORSE) in which cerebrospinal fluid IL-6 was elevated with increased seizure frequency early in the disease: a case report
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- M.D. Nakada Ryoji
- Department of Neurology, The Jikei University School of Medicine
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- M.D., Ph.D. Terasawa Yuka
- Department of Neurology, The Jikei University School of Medicine
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- M.D. Sato Takeo
- Department of Neurology, The Jikei University School of Medicine
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- M.D. Takatsu Hiroki
- Department of Neurology, The Jikei University School of Medicine
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- M.D., Ph.D. Kaito Nobuyoshi
- Department of Neurosurgery, The Jikei University School of Medicine
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- M.D., Ph.D. Iguchi Yasuyuki
- Department of Neurology, The Jikei University School of Medicine
Bibliographic Information
- Other Title
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- 病初期の発作頻度増加に伴い髄液IL-6上昇を認めたcryptogenic new-onset refractory status epilepticus(NORSE)の1例
Abstract
<p>A 25-year-old male presented with clonic seizures three days following a fever. The patient developed status epilepticus and required mechanical ventilation and intravenous anesthesia. The patient’s epileptic seizures persisted despite administering intravenous anesthesia and multiple anti-epileptic drugs. The clinical presentation in this case, without pre-existing relevant neurological disorder and an active structural, toxic, or metabolic cause in the acute phase, was compatible with new-onset refractory status epilepticus (NORSE). After immunotherapy, including intravenous methylprednisolone, plasma exchange, and intravenous immunoglobulin therapy, the epileptic discharge on electroencephalogram (EEG) decreased gradually, and mechanical ventilation was discontinued. Neversless the final outcome was poor. The patient’s condition was finally diagnosed as cryptogenic NORSE. The IL-6 levels in the cerebrospinal fluid showed a significant increase between day 6 and 11 after onset, during which time there was a rapid escalation in seizure frequency on EEG. Considering this, IL-6 may be involved in the process of seizure exacerbation.</p>
Journal
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- Rinsho Shinkeigaku
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Rinsho Shinkeigaku 63 (12), 843-846, 2023
Societas Neurologica Japonica