Reversible Brain Atrophy in Cryptogenic New-onset Refractory Status Epilepticus

Intern Med. 2023 Jun 15;62(12):1835-1842. doi: 10.2169/internalmedicine.0465-22. Epub 2022 Nov 9.

Abstract

Cryptogenic new-onset refractory status epilepticus (C-NORSE) is a neurologic emergency condition characterized by refractory status epilepticus (RSE) of unknown cause. Brain atrophy in a setting of C-NORSE is usually irreversible. A 33-year-old woman who was highly suspected of C-NORSE once showed mild frontotemporal atrophy on brain magnetic resonance imaging (MRI), but follow-up MRI revealed recovery of the brain atrophy. Her cognitive function also gradually improved, with a reduction in seizure frequency. Early initiation of intensive immunotherapy with anti-seizure medications may have minimized irreversible brain damage associated with RSE, resulting in a relatively good outcome.

Keywords: MRI; autoantibodies; cryptogenic new-onset refractory status epilepticus; intensive immunotherapy; reversible brain atrophy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Brain / diagnostic imaging
  • Central Nervous System Diseases* / complications
  • Female
  • Humans
  • Magnetic Resonance Imaging / adverse effects
  • Neurodegenerative Diseases* / complications
  • Status Epilepticus* / diagnostic imaging
  • Status Epilepticus* / drug therapy
  • Status Epilepticus* / etiology