TY - JOUR
T1 - Partial Status Epilepticus with Paradoxical Protein-Cytologic Dissociation in Cerebrospinal Fluid
AU - Singh, Neeraj
AU - Lansing, John J.
AU - Polavarapu, Aparna
N1 - Publisher Copyright:
© 2020 Georg Thieme Verlag. All rights reserved.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Status epilepticus is associated with high morbidity and mortality, often requiring multiple drug interventions and intensive care monitoring. Etiology of status epilepticus plays a crucial role in the treatment, natural course and outcome of the patient, prompting extensive testing and imaging. For example, an important risk for status epilepticus in adults and children is the presence of an underlying viral or bacterial central nervous system infection, appropriate treatment of which can improve the outcome of the patient. We present three cases of new-onset refractory status epilepticus in women who did not have evidence of a central nervous system infection and had significantly elevated leukocytes compared to protein in the cerebrospinal fluid. This finding suggests an autoimmune etiology; however, standard autoimmune testing was unremarkable in all cases. This case series highlights the variability in presentation and clinical course in patients presenting with status epilepticus of unknown cause, and we discuss the importance of further research into appropriate and reliable diagnostic evaluations.
AB - Status epilepticus is associated with high morbidity and mortality, often requiring multiple drug interventions and intensive care monitoring. Etiology of status epilepticus plays a crucial role in the treatment, natural course and outcome of the patient, prompting extensive testing and imaging. For example, an important risk for status epilepticus in adults and children is the presence of an underlying viral or bacterial central nervous system infection, appropriate treatment of which can improve the outcome of the patient. We present three cases of new-onset refractory status epilepticus in women who did not have evidence of a central nervous system infection and had significantly elevated leukocytes compared to protein in the cerebrospinal fluid. This finding suggests an autoimmune etiology; however, standard autoimmune testing was unremarkable in all cases. This case series highlights the variability in presentation and clinical course in patients presenting with status epilepticus of unknown cause, and we discuss the importance of further research into appropriate and reliable diagnostic evaluations.
KW - NORSE
KW - autoimmune encephalitis
KW - new-onset refractory status epilepticus
KW - paraneoplastic syndrome
KW - partial status epilepticus
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U2 - 10.1055/s-0040-1716432
DO - 10.1055/s-0040-1716432
M3 - Article
AN - SCOPUS:85091433810
SN - 2213-6320
VL - 6
SP - 59
EP - 64
JO - International Journal of Epilepsy
JF - International Journal of Epilepsy
IS - 2
M1 - IJEP1800066
ER -