{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T22:24:53Z","timestamp":1785450293872,"version":"3.56.0"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T00:00:00Z","timestamp":1713398400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100024075","name":"Region Syddanmark","doi-asserted-by":"publisher","award":["A949"],"award-info":[{"award-number":["A949"]}],"id":[{"id":"10.13039\/501100024075","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003554","name":"Lundbeck Foundation","doi-asserted-by":"publisher","award":["R434\u20102023\u2010342"],"award-info":[{"award-number":["R434\u20102023\u2010342"]}],"id":[{"id":"10.13039\/501100003554","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013814","name":"Klinisk Institut, Syddansk Universitet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013814","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>The mechanisms causing new onset refractory status epilepticus (NORSE) are often unknown. Recently, a seasonal variation with NORSE peaking during the summer was described in a mixed cohort of adults and children why we here studied the seasonal variation in a Danish status epilepticus (SE) cohort. This retrospective cohort study comprised SE patients aged \u226518 diagnosed and treated 2008\u20132017 at the Odense University Hospital. Clinical characteristics and seasonality of patients fulfilling the diagnostic criteria for NORSE were compared with patients with refractory SE (RSE) due to other reasons and with the seasonal variation of autoantibodies associated with autoimmune encephalitis in the Danish autoimmune encephalitis register. In this cohort, 26 patients met NORSE criteria. As compared to RSE patients not fulfilling NORSE criteria (<jats:italic>n<\/jats:italic>\u2009=\u2009152), NORSE patients were more likely to have symptoms of systemic inflammation (C\u2010reactive protein concentrations \u226510\u2009mg\/L or fever \u226538\u00b0C) at admission; nine fulfilled the criteria for febrile infection related epilepsy syndrome (FIRES). In contrast to the even seasonal distribution of patients with RSE not fulfilling the NORSE criteria, admissions due to NORSE peaked during the winter (46.1%, <jats:italic>p<\/jats:italic>\u2009=\u20090.04 as compared to non\u2010NORSE RSE); six out of nine FIRES episodes occurred in the winter season. The seasonal variation was not explained by a seasonal variation of the detection rates of autoantibodies associated with autoimmune encephalitis (incl. NMDAR, LGI1, CASPR2, GABAR, GFAP) in a Danish nationwide register (<jats:italic>n<\/jats:italic>\u2009=\u2009259). In conclusion, we confirm the seasonality of NORSE in a Danish cohort, however, with a peak during winter suggesting a geographical variation not solely explained by autoimmune encephalitis associated with known autoantibodies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Plain Language Summary<\/jats:title><jats:p>The study investigated the seasonal patterns of new\u2010onset refractory status epilepticus (NORSE), i.e. severe seizures that occur without an obvious cause and require very intensive treatment. In contrast to the previously observed peak frequency in summer, this Danish study found that NORSE cases peak in winter. Furthermore, the seasonal variation in NORSE cases was not found to be associated with autoimmune encephalitis caused by known autoantibodies. Together with the high rate of patients showing symptoms of systemic inflammation compared to other status epilepticus patients, the data suggest a link between misdirected immune system responses and NORSE. The study can therefore help in the further search for the currently unknown causes of NORSE.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epi4.12944","type":"journal-article","created":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T14:49:06Z","timestamp":1713451746000},"page":"1088-1095","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["<scp>NORSE<\/scp> seasonality may vary geographically in adults"],"prefix":"10.1002","volume":"9","author":[{"given":"Andrea Enerstad","family":"Bolle","sequence":"first","affiliation":[{"name":"Department of Neurology Odense University Hospital  Odense Denmark"},{"name":"BRIDGE \u2013 Brain Research Inter Disciplinary Guided Excellence Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Gaist","sequence":"additional","affiliation":[{"name":"Department of Neurology Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Maria Eleonora","family":"Kuljis","sequence":"additional","affiliation":[{"name":"Department of Neurology Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten","family":"Blaabjerg","sequence":"additional","affiliation":[{"name":"Department of Neurology Odense University Hospital  Odense Denmark"},{"name":"BRIDGE \u2013 Brain Research Inter Disciplinary Guided Excellence Odense University Hospital  Odense Denmark"},{"name":"Department of Clinical Research University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8268-1492","authenticated-orcid":false,"given":"Christoph Patrick","family":"Beier","sequence":"additional","affiliation":[{"name":"Department of Neurology Odense University Hospital  Odense Denmark"},{"name":"BRIDGE \u2013 Brain Research Inter Disciplinary Guided Excellence Odense University Hospital  Odense Denmark"},{"name":"Department of Clinical Research University of Southern Denmark  Odense Denmark"},{"name":"OPEN, Open Patient Data Explorative Network Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,18]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.26579"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2020.107487"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2007.08.020"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17397"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17523"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.2174\/1871527319666200708133103"},{"key":"e_1_2_11_8_1","first-page":"1","article-title":"The seasonality of new\u2010onset refracotry status epilepticus (NORSE)","volume":"2","author":"Gopaul MT","year":"2023","journal-title":"Epilepsia"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2022.0609"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.14602"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_2_11_12_1","first-page":"527","article-title":"Refractory status epilepticus: is there room for grading refractoriness?","volume":"2","author":"Lattanzi S","year":"2023","journal-title":"Epilepsia"},{"issue":"2","key":"e_1_2_11_13_1","first-page":"559","article-title":"Management of Status Epilepticus, refractory status epilepticus, and super\u2010refractory status epilepticus","volume":"28","author":"Trinka E","year":"2022","journal-title":"Continuum"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17817"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.14016"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2018.07.009"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-021-10738-9"},{"key":"e_1_2_11_18_1","volume-title":"Measuring seasonality. Seasonality in human mortality: a demographic approach","author":"Rau R","year":"2007"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2021.577673"},{"issue":"6","key":"e_1_2_11_20_1","first-page":"1525","article-title":"Spatial and ecological factors modulate the incidence of anti\u2010NMDAR encephalitis \u2013 a systematic review","volume":"11","author":"Alentorn A","year":"2023","journal-title":"Biomedicine"},{"key":"e_1_2_11_21_1","first-page":"1","article-title":"Cytokines in noe\u2010onset refractory status epilepticus predict outcomes","volume":"1","author":"PharmD AH","year":"2023","journal-title":"Ann Neurol"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.15149"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-015-1481-5"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.26627"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17755"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-virology-012420-022445"}],"container-title":["Epilepsia Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi4.12944","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T12:09:06Z","timestamp":1717416546000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/epi4.12944"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,18]]},"references-count":25,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1002\/epi4.12944"],"URL":"https:\/\/doi.org\/10.1002\/epi4.12944","archive":["Portico"],"relation":{},"ISSN":["2470-9239","2470-9239"],"issn-type":[{"value":"2470-9239","type":"print"},{"value":"2470-9239","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,18]]},"assertion":[{"value":"2023-12-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}