Shrivastava Manisha, Chouhan Smita, Navaid Seema
Professor, Departmemt of Transfusion Medicine, Bhopal Memorial Hospital and Research Center, Bhopal, Madhya Pradesh, India.
Senior Consultant, Department of Transfusion Medicine, Bhopal Memorial Hospital and Research Center, Bhopal, Madhya Pradesh, India.
J Clin Diagn Res. 2017 Jul;11(7):ED33-ED34. doi: 10.7860/JCDR/2017/29878.10292. Epub 2017 Jul 1.
Refractory Status Epilepticus (RSE) not responding to any therapy and not associated with any aetiology has been termed as New Onset Refractory Status Epilepticus (NORSE). Guidelines for optimal management of cryptogenic NORSE are not clearly defined so far in the literature. Other than common medication, use of high-dose steroids, IV immune globulins and plasma exchanges in NORSE of unknown aetiology have been scarcely described. Immunomodulatory therapy like plasmapheresis is based on the fact that a pathological substance exists in the plasma that contributes to the disease process and its symptoms, which gets removed. We report a case of young female patient diagnosed as NORSE who responded to treatment with plasma exchange after becoming refractory to antiepileptic therapy and treatment with anaesthetic agents for recurrent seizers.
对任何治疗均无反应且无任何病因的难治性癫痫持续状态(RSE)被称为新发难治性癫痫持续状态(NORSE)。迄今为止,文献中尚未明确界定隐源性NORSE的最佳管理指南。除常用药物外,关于病因不明的NORSE使用大剂量类固醇、静脉注射免疫球蛋白和血浆置换的描述很少。像血浆置换这样的免疫调节疗法基于这样一个事实,即血浆中存在一种导致疾病进程及其症状的病理性物质,而这种物质会被清除。我们报告一例年轻女性患者,诊断为NORSE,在对抗癫痫治疗和使用麻醉剂治疗反复癫痫发作均无效后,经血浆置换治疗取得了疗效。