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Intravenous immunoglobulin response in new-onset refractory status epilepticus (NORSE) COVID-19 adult patients
Neurological manifestations may be common in COVID-19 patients. They may include several syndromes, such as a suggested autoimmune abnormal response, which may result in encephalitis and new-onset refractory status epilepticus (NORSE). Quickly recognizing such cases and starting the most appropriate...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7951121/ https://www.ncbi.nlm.nih.gov/pubmed/33709220 http://dx.doi.org/10.1007/s00415-021-10468-y |
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author | Manganotti, Paolo Furlanis, Giovanni Ajčević, Miloš Moras, Cristina Bonzi, Lucia Pesavento, Valentina Buoite Stella, Alex |
author_facet | Manganotti, Paolo Furlanis, Giovanni Ajčević, Miloš Moras, Cristina Bonzi, Lucia Pesavento, Valentina Buoite Stella, Alex |
author_sort | Manganotti, Paolo |
collection | PubMed |
description | Neurological manifestations may be common in COVID-19 patients. They may include several syndromes, such as a suggested autoimmune abnormal response, which may result in encephalitis and new-onset refractory status epilepticus (NORSE). Quickly recognizing such cases and starting the most appropriate therapy is mandatory due to the related rapid worsening and bad outcomes. This case series describes two adult patients admitted to the university hospital and positive to novel coronavirus 2019 (SARS-CoV-2) infection who developed drug-resistant status epilepticus. Both patients underwent early electroencephalography (EEG) assessment, which showed a pathological EEG pattern characterized by general slowing, rhythmic activity and continuous epileptic paroxysmal activity. A suspected autoimmune etiology, potentially triggered by SARS-CoV-2 infection, encouraged a rapid work-up for a possible autoimmune encephalitis diagnosis. Therapeutic approach included the administration of 0.4 g/kg intravenous immunoglobulin, which resulted in a complete resolution of seizures after 5 and after 10 days, respectively, without adverse effects and followed by a normalization of the EEG patterns. |
format | Online Article Text |
id | pubmed-7951121 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-79511212021-03-12 Intravenous immunoglobulin response in new-onset refractory status epilepticus (NORSE) COVID-19 adult patients Manganotti, Paolo Furlanis, Giovanni Ajčević, Miloš Moras, Cristina Bonzi, Lucia Pesavento, Valentina Buoite Stella, Alex J Neurol Original Communication Neurological manifestations may be common in COVID-19 patients. They may include several syndromes, such as a suggested autoimmune abnormal response, which may result in encephalitis and new-onset refractory status epilepticus (NORSE). Quickly recognizing such cases and starting the most appropriate therapy is mandatory due to the related rapid worsening and bad outcomes. This case series describes two adult patients admitted to the university hospital and positive to novel coronavirus 2019 (SARS-CoV-2) infection who developed drug-resistant status epilepticus. Both patients underwent early electroencephalography (EEG) assessment, which showed a pathological EEG pattern characterized by general slowing, rhythmic activity and continuous epileptic paroxysmal activity. A suspected autoimmune etiology, potentially triggered by SARS-CoV-2 infection, encouraged a rapid work-up for a possible autoimmune encephalitis diagnosis. Therapeutic approach included the administration of 0.4 g/kg intravenous immunoglobulin, which resulted in a complete resolution of seizures after 5 and after 10 days, respectively, without adverse effects and followed by a normalization of the EEG patterns. Springer Berlin Heidelberg 2021-03-11 2021 /pmc/articles/PMC7951121/ /pubmed/33709220 http://dx.doi.org/10.1007/s00415-021-10468-y Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Communication Manganotti, Paolo Furlanis, Giovanni Ajčević, Miloš Moras, Cristina Bonzi, Lucia Pesavento, Valentina Buoite Stella, Alex Intravenous immunoglobulin response in new-onset refractory status epilepticus (NORSE) COVID-19 adult patients |
title | Intravenous immunoglobulin response in new-onset refractory status epilepticus (NORSE) COVID-19 adult patients |
title_full | Intravenous immunoglobulin response in new-onset refractory status epilepticus (NORSE) COVID-19 adult patients |
title_fullStr | Intravenous immunoglobulin response in new-onset refractory status epilepticus (NORSE) COVID-19 adult patients |
title_full_unstemmed | Intravenous immunoglobulin response in new-onset refractory status epilepticus (NORSE) COVID-19 adult patients |
title_short | Intravenous immunoglobulin response in new-onset refractory status epilepticus (NORSE) COVID-19 adult patients |
title_sort | intravenous immunoglobulin response in new-onset refractory status epilepticus (norse) covid-19 adult patients |
topic | Original Communication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7951121/ https://www.ncbi.nlm.nih.gov/pubmed/33709220 http://dx.doi.org/10.1007/s00415-021-10468-y |
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