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Consciousness Recovery by Rituximab after Seizure Control in Cryptogenic New-Onset Refractory Status Epilepticus

잠복신발현난치뇌전증지속상태에서 발작이 조절된 후에 투여한 리툭시맙에 의한 의식 회복

  • Yang, Tae-Won (Department of Neurology, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine) ;
  • Jo, Jeong Won (Department of Dermatology, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine) ;
  • Kim, Do-Hyung (Department of Neurology and Institute of Health Science, Gyeongsang National University College of Medicine) ;
  • Kim, Young-Soo (Department of Neurology and Institute of Health Science, Gyeongsang National University College of Medicine) ;
  • Kwon, Oh-Young (Department of Neurology and Institute of Health Science, Gyeongsang National University College of Medicine)
  • 양태원 (경상대학교 의과대학 창원경상대학교병원 신경과) ;
  • 조정원 (경상대학교 의과대학 경상대학교병원 피부과) ;
  • 김도형 (경상대학교 의과대학 신경과학교실 및 건강과학연구원) ;
  • 김영수 (경상대학교 의과대학 신경과학교실 및 건강과학연구원) ;
  • 권오영 (경상대학교 의과대학 신경과학교실 및 건강과학연구원)
  • Received : 2018.10.31
  • Accepted : 2018.12.07
  • Published : 2018.12.30

Abstract

Background: New-onset refractory status epilepticus (NORSE) occurs in people without a history of seizures. In these cases, the seizure causes are unclear, and the seizures are not controlled by standard treatment. Autoimmune encephalitis (AIE) can be a cause of NORSE. Cryptogenic NORSE may be associated with AIE, but antibodies associated with the condition have not yet been identified. Primary immunotherapy may not be effective for AIE. Rituximab has improved the prognosis in some cases. Case Report: We treated a cryptogenic NORSE patient with a combination of antiepileptic drugs and immunotherapy. On the 13th hospital day, the seizures were controlled, but the patient remained in a coma. The patient rapidly recovered after administration of rituximab started on the 26th hospital day. Conclusion: Rituximab may be helpful for cryptogenic NORSE patients in whom primary immunotherapy controls seizures, but fails to improve consciousness.

Keywords

References

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