Refractory status epilepticus arrested by vagus nerve stimulation

被引:2
|
作者
Mehboob, Sadaf [1 ]
Sureshkumar, Soorya Mukkadayil [1 ]
Fernandes, Linford [1 ]
Wright, Elizabeth [1 ]
Ray, Munni [2 ]
Goodden, John [3 ]
Maguire, Melissa [1 ]
机构
[1] Leeds Teaching Hosp NHS Trust, Dept Neurol, Leeds LS1 3EX, England
[2] Leeds Teaching Hosp NHS Trust, Dept Neurophysiol, Leeds, England
[3] Leeds Teaching Hosp NHS Trust, Dept Neurosurg, Leeds, England
关键词
EEG; epilepsy; electrical stimulation;
D O I
10.1136/pn-2023-003896
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
A 54-year-old man developed altered mental state and generalised tonic-clonic seizures after 1 week of upper respiratory tract symptoms and diarrhoea, having been previously well. His MR scan of brain showed multifocal progressive T2 cortical signal changes. He was diagnosed with new-onset refractory status epilepticus (NORSE), initially treated as being secondary to autoimmune/paraneoplastic limbic encephalitis, although subsequent investigations were negative. His seizures and electrographic epileptiform activity continued despite escalating doses of antiseizure medications, immunosuppression with corticosteroids, immunoglobulins, plasma exchange and rituximab, and thereafter anaesthetic agents. A vagus nerve stimulator (VNS) was implanted 6 weeks after admission and its voltage rapidly increased over 4 days; his seizure activity resolved in the third week after VNS implantation. This case highlights the role of VNS in the early management of NORSE.
引用
收藏
页码:129 / 133
页数:5
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