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CC BY-NC-ND 4.0 · International Journal of Epilepsy 2020; 6(02): 59-64
DOI: 10.1055/s-0040-1716432
Case Report

Partial Status Epilepticus with Paradoxical Protein-Cytologic Dissociation in Cerebrospinal Fluid

Neeraj Singh
1   Department of Neurosciences, Northwell Health, New York, United States
2   Department of Neurology, Albany Medical Center, Albany, New York, United States
,
John J. Lansing
2   Department of Neurology, Albany Medical Center, Albany, New York, United States
,
Aparna Polavarapu
3   Department of Neurology, Nemours A.I. DuPont Hospital for Children, Delaware, United States
4   Department of Neurology, Montefiore Medical Center, Bronx, New York, United States
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Abstract

Status epilepticus is associated with high morbidity and mortality, often requiring multiple drug interventions and intensive care monitoring. Etiology of status epilepticus plays a crucial role in the treatment, natural course and outcome of the patient, prompting extensive testing and imaging. For example, an important risk for status epilepticus in adults and children is the presence of an underlying viral or bacterial central nervous system infection, appropriate treatment of which can improve the outcome of the patient. We present three cases of new-onset refractory status epilepticus in women who did not have evidence of a central nervous system infection and had significantly elevated leukocytes compared to protein in the cerebrospinal fluid. This finding suggests an autoimmune etiology; however, standard autoimmune testing was unremarkable in all cases. This case series highlights the variability in presentation and clinical course in patients presenting with status epilepticus of unknown cause, and we discuss the importance of further research into appropriate and reliable diagnostic evaluations.

Keywords

autoimmune encephalitis - new-onset refractory status epilepticus - NORSE - paraneoplastic syndrome - partial status epilepticus


Publication History

Article published online:
11 September 2020

© 2020. Indian Epilepsy Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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