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After 3 days of a febrile illness, a previously well 19 years old developed focal seizures with loss of awareness. The seizures progressed to generalised tonic-clonic seizures and convulsive status epilepticus requiring sedation and ventilation in intensive care. cEEG during in ICU shown below. What would be the likely diagnosis?
Explanation
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While earlier literature generally used NORSE for adult patients and FIRES for children, working definitions do not make this distinction, and both terms now apply in all ages<br><br>Three common early patterns<br>- initially infrequent seizures gradually evolving into status epilepticus<br>- beta-delta complex resembling delta brushes<br>- characteristic seizure onset pattern with focal fast activity with shifting seizures<br><br>Other patterns reported in Adults periodic discharges (generalised, lateralised, bilateral independent and multifocal) and multiple seizure patterns (generalised, focal and multifocal)
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Reference
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Mantoan RitterL,NashefL. New-onset refractory status epilepticus (NORSE)Practical Neurology2021
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Option 1
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Is Correct (Option 1):
Brain abscess
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Option 2
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Is Correct (Option 2):
Cerebral venous sinus thrombosis
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Option 3
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Is Correct (Option 3):
HSV encephalits
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Option 4
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Is Correct (Option 4):
NORSE
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