Plasma Exchange as a Therapeutic Modality in a Rare Case of Cryptogenic New Onset Refractory Status Epilepticus (NORSE) ED33-ED34
Dr. Manisha Shrivastava,
A-9 Bhopal Memorial Hospital and Research Center Campus, Bhopal-462038, Madhya Pradesh, India.
Refractory Status Epilepticus (RSE) not responding to any therapy and not associated with any aetiology has been termed as New Onset Refractory Status Epilepticus (NORSE). Guidelines for optimal management of cryptogenic NORSE are not clearly defined so far in the literature. Other than common medication, use of high-dose steroids, IV immune globulins, and plasma exchanges in NORSE of unknown aetiology have been scarcely described. Immunomodulatory therapy like plasmapheresis is based on the fact that a pathological substance exists in the plasma that contributes to the disease process and its symptoms, which gets removed. We report a case of young female patient diagnosed as NORSE who responded to treatment with plasma exchange after becoming refractory to antiepileptic therapy and treatment with anaesthetic agents for recurrent seizers.