잠복신발현난치뇌전증지속상태에서 발작이 조절된 후에 투여한 리툭시맙에 의한 의식 회복

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 assoc...

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Veröffentlicht in:Journal of neurocritical care 2018, 11(2), , pp.137-142
Hauptverfasser: 양태원, 조정원, 김도형(경상대학교 의과대학 신경과학교실 및 건강과학연구원, 경상대학교병원 신경과), 김영수(경상대학교, 경상대학교병원), 권오영(경상대학교
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Zusammenfassung: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. Conclusions: Rituximab may be helpful for cryptogenic NORSE patients in whom primary immunotherapy controls seizures, but fails to improve consciousness. KCI Citation Count: 0
ISSN:2005-0348
2508-1349
DOI:10.18700/jnc.180066