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Long‐term outcomes after NORSE: Treatment with vagus nerve stimulation

New‐onset refractory status epilepticus (NORSE) is associated with high mortality, therapy‐resistant epilepsy (TRE), and poor cognitive and functional outcomes. Some patients develop multifocal TRE, for whom surgery with a curative intention, is not an option. In these patients, vagus nerve stimulat...

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Autores principales: Espino, Poul H., Burneo, Jorge G., Moscol, Gaby, Gofton, Teneille, MacDougall, Keith, Suller Marti, Ana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9712472/
https://www.ncbi.nlm.nih.gov/pubmed/36177520
http://dx.doi.org/10.1002/epi4.12654
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author Espino, Poul H.
Burneo, Jorge G.
Moscol, Gaby
Gofton, Teneille
MacDougall, Keith
Suller Marti, Ana
author_facet Espino, Poul H.
Burneo, Jorge G.
Moscol, Gaby
Gofton, Teneille
MacDougall, Keith
Suller Marti, Ana
author_sort Espino, Poul H.
collection PubMed
description New‐onset refractory status epilepticus (NORSE) is associated with high mortality, therapy‐resistant epilepsy (TRE), and poor cognitive and functional outcomes. Some patients develop multifocal TRE, for whom surgery with a curative intention, is not an option. In these patients, vagus nerve stimulation (VNS) is performed as a palliative treatment. We report the long‐term outcomes regarding seizure frequency, functional and cognitive outcome, and effectiveness of VNS in two patients with TRE as a consequence of NORSE. In the first patient with cryptogenic NORSE, VNS implantation occurred during the acute stage, probably contributing to the cessation of her status epilepticus. However, in the long‐term follow‐up, the patient persisted with daily multifocal seizures. In the second patient, VNS implantation was delayed to manage his epilepsy when the NORSE, ultimately due to autoimmune encephalitis, had resolved. During long‐term follow‐up, no reduction in seizure frequency was achieved. This evidence supporting the use of VNS in patients with TRE after NORSE warrants further investigation.
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spelling pubmed-97124722022-12-02 Long‐term outcomes after NORSE: Treatment with vagus nerve stimulation Espino, Poul H. Burneo, Jorge G. Moscol, Gaby Gofton, Teneille MacDougall, Keith Suller Marti, Ana Epilepsia Open Short Research Articles New‐onset refractory status epilepticus (NORSE) is associated with high mortality, therapy‐resistant epilepsy (TRE), and poor cognitive and functional outcomes. Some patients develop multifocal TRE, for whom surgery with a curative intention, is not an option. In these patients, vagus nerve stimulation (VNS) is performed as a palliative treatment. We report the long‐term outcomes regarding seizure frequency, functional and cognitive outcome, and effectiveness of VNS in two patients with TRE as a consequence of NORSE. In the first patient with cryptogenic NORSE, VNS implantation occurred during the acute stage, probably contributing to the cessation of her status epilepticus. However, in the long‐term follow‐up, the patient persisted with daily multifocal seizures. In the second patient, VNS implantation was delayed to manage his epilepsy when the NORSE, ultimately due to autoimmune encephalitis, had resolved. During long‐term follow‐up, no reduction in seizure frequency was achieved. This evidence supporting the use of VNS in patients with TRE after NORSE warrants further investigation. John Wiley and Sons Inc. 2022-10-09 /pmc/articles/PMC9712472/ /pubmed/36177520 http://dx.doi.org/10.1002/epi4.12654 Text en © 2022 The Authors. Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Short Research Articles
Espino, Poul H.
Burneo, Jorge G.
Moscol, Gaby
Gofton, Teneille
MacDougall, Keith
Suller Marti, Ana
Long‐term outcomes after NORSE: Treatment with vagus nerve stimulation
title Long‐term outcomes after NORSE: Treatment with vagus nerve stimulation
title_full Long‐term outcomes after NORSE: Treatment with vagus nerve stimulation
title_fullStr Long‐term outcomes after NORSE: Treatment with vagus nerve stimulation
title_full_unstemmed Long‐term outcomes after NORSE: Treatment with vagus nerve stimulation
title_short Long‐term outcomes after NORSE: Treatment with vagus nerve stimulation
title_sort long‐term outcomes after norse: treatment with vagus nerve stimulation
topic Short Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9712472/
https://www.ncbi.nlm.nih.gov/pubmed/36177520
http://dx.doi.org/10.1002/epi4.12654
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