J Neurocrit Care.  2018 Dec;11(2):137-142. 10.18700/jnc.180066.

Consciousness Recovery by Rituximab after Seizure Control in Cryptogenic New-Onset Refractory Status Epilepticus

Affiliations
  • 1Department of Neurology, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea.
  • 2Department of Dermatology, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea.
  • 3Department of Neurology and Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Korea. mnkwon21@daum.net, oykwon@gnu.ac.kr
  • 4Department of Neurology, Gyeongsang National University Hospital, Jinju, Korea.

Abstract

BACKGROUND
New-onset refractory status epilepticus (NORSE) occurs in people without a history of seizures. In these cases, the seizure causes are unclear, and the seizures are not controlled by standard treatment. Autoimmune encephalitis (AIE) can be a cause of NORSE. Cryptogenic NORSE may be associated with AIE, but antibodies associated with the condition have not yet been identified. Primary immunotherapy may not be effective for AIE. Rituximab has improved the prognosis in some cases.
CASE REPORT
We treated a cryptogenic NORSE patient with a combination of antiepileptic drugs and immunotherapy. On the 13th hospital day, the seizures were controlled, but the patient remained in a coma. The patient rapidly recovered after administration of rituximab started on the 26th hospital day.
CONCLUSION
Rituximab may be helpful for cryptogenic NORSE patients in whom primary immunotherapy controls seizures, but fails to improve consciousness.

Keyword

Status epilepticus; Immunotherapy; Rituximab; Consciousness

MeSH Terms

Antibodies
Anticonvulsants
Coma
Consciousness*
Encephalitis
Humans
Immunotherapy
Prognosis
Rituximab*
Seizures*
Status Epilepticus*
Antibodies
Anticonvulsants
Rituximab
Full Text Links
  • JNC
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
    DB Error: unknown error