Abstract
Objective: New-onset refractory status epilepticus (NORSE) is rare, clinical symptoms and characteristics on magnetic resonance imaging (MRI) are diverse, sometimes difficult to recognize, sometimes the cause cannot be determined and it is very difficult to treat. This article describes the clinical signs and MRI characteristics of patients presented with New-onset refractory status epilepticus at the Neurology Center of Bach Mai Hospital. Subjects and Methods: A cross-sectional descriptive study in which data were retrospectively collected from 34 NORSE-patients treated in Neurology Center – Bach Mai Hospital from February 2023 to January 2025. Results: 34 patients were presented with new-onset refractory status epilepticus, of which the male/female ratio was 15/19 (= 0.79). The average age is 38.29 ± 19.09 years (range from 16 - 73 years). Regarding the cause of NORSE, 18 patients (52.9%) were cryptogenic – NORSE, 13 patients (38.2%) were diagnosed autoimmune encephalitis. There were 20 patients with focal onset evolving into bilateral convulsive SE (58.8%), 9 patients with focal motor SE (26.5%), and 5 patients with generalized convulsive SE (14.7%). The prodrome symptoms are fever (32.4%), confuse (55.9%), fatigue (47.1%), sleep disorder (14.7%), headache (35.3%), memory disorders (29.4%), and upper respiratory tract infection (12.8%). All patients received magnetic resonance imaging (MRI) with an abnormality rate of 55.9% on MRI, including 12 patients with unilateral hemispheric lesions (35.3%) and 7 patients with bilateral lesions (20.6%). Conclusion: The clinical signs and MRI characteristics manifestations of NORSE-patients is highly variable.
