Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
New-onset Refractory Status Epilepticus Involving the Limbic System, Spinal Cord, and Peripheral Nerves
Kensuke DaidaKenya NishiokaMasashi TakanashiManami KobayashiKeisuke YoshikawaSusumu KusunokiKazumasa YokoyamaNobutaka Hattori
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JOURNALS OPEN ACCESS

2020 Volume 59 Issue 2 Pages 267-270

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Abstract

A healthy 28-year-old woman presented suddenly with intractable status epilepticus: a focal seizure evolved into a generalized seizure preceded by a high fever. Brain magnetic resonance imaging indicated bilateral hyperintensities in the hippocampus on T2-weighted imaging. Electroencephalograms continuously demonstrated diffuse sharp waves and poly-spikes. Comprehensive immunomodulation therapies and anti-epileptic drugs did not lead to any improvements. We therefore diagnosed her with cryptogenic limbic encephalitis and new-onset refractory status epilepticus (NORSE). We detected positive anti-ganglioside antibodies, IgG-GQ1b, GD1a, and GT1b, which were negative at six months after the onset. We emphasize the heterogeneous pathogenesis and intractable conditions of NORSE.

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© 2020 by The Japanese Society of Internal Medicine
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