Abstracts

Rationale: New-onset refractory status epilepticus (NORSE) is an uncommon condition characterized by acute or subacute onset of refractory seizures and status epilepticus. In the absence of an obvious structural lesion or CNS infection, the etiology often remains unknown. Treatable autoimmune or infectious causes are sometimes discovered, though often after a significant delay, causing delays in treatment and sometimes negatively affecting outcome. Methods: In this multicenter retrospective series of patients with new-onset refractory status epilepticus or seizures without an immediately identifiable cause, we aimed to determine the utility of early clinical and electroencephalographic findings that could indicate underlying etiology. Results: We identified 19 adult cases in 7 academic centers. Median age was 51 year (range 18-49). 14 patients were female. Etiologies are summarized in Table 1. The main clinical and EEG findings and their association with specific etiologies are detailed in Table 2. Conclusions: Determining the etiology of status epilepticus is necessary to optimize treatment and possibly improve outcome but is often delayed from symptom onset. This series shows that early clinical and EEG findings can be valuable clues to the early recognition of potentially treatable conditions.