Rare complication of carotid stenting: New-onset refractory status epilepticus: A study of five patients

The etiology and mortality of new‐onset refractory status epilepticus (NORSE) in adults: A systematic review and meta‐analysis

“…10,56,57 Unspecified autoimmune etiology was classified as such when investigation panels rendered seronegative results, but where an autoimmune basis was strongly suspected: a diagnosis based on the "holistic" view of the clinical presentation, taking into consideration the history, imaging result, cerebrospinal fluid (CSF) analysis, and exclusion of other etiologies. 58,59 Genetic causes were mitochondrial in origin, 60,61 vascular comprised ischemic pathologies, 23,26,62 structural were any neuroanatomical issues, such as reversible corpus callosum lesions, 63,64 and toxins included synthetic cannabinoid use and alcohol. 6,10,65 All included etiologies were identified only after a negative initial diagnostic workup in the first 72 h of presentation.…”

“…Commonly used anesthetics were propofol, midazolam, pentobarbital, and ketamine. All but two studies reported the use of immunotherapies, 2,23 of which intravenous immunoglobulin (IVIG), plasma exchange (PLEX), and corticosteroids were the most common. Other immunosuppressants reported were rituximab, cyclophosphamide, tocilizumab, aldeslukin, bortezomib, tacrolimus, everolimus, cyclosporin, and methotrexate.…”

“…When excluding the two studies where use of immunotherapy was not mentioned (pooled proportion of mortality = .22, 95% CI .17-.28), 2,23 or where mortality included brain deaths or chronic deaths occurring after discharge (pooled proportion of mortality = .21, 95% CI .16-.27), 66 the overall result did not differ significantly. Because all the included studies were case series and of high or unclear risk of bias, a sensitivity analysis including highquality studies could not be performed.…”

“…Individual patient-level data were extracted for nine studies, 1,[21][22][23][24][25][26][27][28] and aggregate data were collected for the six remaining studies 2,3,10,29-31 ; 63.3% were female, with a mean age of 42.3 years (range 16-90) across 14 studies. Study settings varied and included seven studies in the United States, 2,10,22,26,28,30,31 two studies in the UK, 21,24 two studies in Korea, 25,29 one in India, 23 one in Japan, 3 one in China, 27 and one in Singapore. 1 Because all studies were case series or case reports, they were assessed as having a high risk of bias.…”