Limbic and new onset refractory tonic status epilepticus (NORSE) in anti-NMDAR encephalitis

Peter W Kaplan; John Probasco

doi:10.1016/j.cnp.2017.06.003

Limbic and new onset refractory tonic status epilepticus (NORSE) in anti-NMDAR encephalitis

Clin Neurophysiol Pract. 2017 Jul 1:2:140-143. doi: 10.1016/j.cnp.2017.06.003. eCollection 2017.

Authors

Peter W Kaplan¹, John Probasco²

Affiliations

¹ Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, USA.
² Johns Hopkins Hospital, Johns Hopkins University School of Medicine, USA.

Abstract

Aims: To present a case of anti-NMDA receptor encephalitis (anti-NMDAR) with new onset refractory non-convulsive status epilepticus (NORSE).

Methods: Case report with clinical details, MRI, PET, and EEG illustrations.

Results: New onset refractory status epilepticus (NORSE) may arise from anti-NMDAR, and offers diagnostic and treatment challenges for immuno-therapy and refractory status epilepticus. Non-convulsive status epilepticus with generalized fast activity, has not been reported in anti-NMDAR, in NORSE.

Conclusions: A patient with anti-NMDAR and generalized status with stiffening, right focal weakness, high frequency alpha/beta on EEG, brain FDG-PET/CT changes in the left temporo-parietal regions and cerebellum was presented. We discuss the unique treatment challenges of anti-NMDAR. NORSE and generalized nonconvulsive status epilepticus.

Keywords: Anti-NMDAR; Limbic encephalitis; Limbic status epilepticus; NORSE; Tonic status epilepticus.

Publication types

Case Reports