{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:06:03Z","timestamp":1788303963761,"version":"build-2803163510"},"reference-count":44,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T00:00:00Z","timestamp":1746144000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study was undertaken to describe a case series of Brazilian new onset refractory status epilepticus (NORSE) patients and evaluate the sensitivity and specificity of a clinical score to predict cryptogenic etiology (c\u2010NORSE score) after autoimmune encephalitis (AE) testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty\u2010seven patients with NORSE from the Brazilian Autoimmune Encephalitis Network were investigated with brain magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis, and complementary testing with tissue\u2010based assays and cell\u2010based assays for antineuronal and antiglial antibodies (abs) in serum\/CSF. Final diagnoses were compiled after chart review. Patients were allocated into two groups according to c\u2010NORSE score: (\u22655) high score (HS) or (&lt;5) low score (LS), and clinical variables were compared. c\u2010NORSE score sensitivity and specificity were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We found that 23 (62%) of the NORSE patients were children, 49% were female, 22% had AE, and 51% were classified as c\u2010NORSE. Eleven patients (30%) were allocated to the HS group and 26 (70%) to LS. Bilateral and symmetric MRI findings were more frequent in the HS group (HS 100% vs. LS 43%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.018), whereas memory or behavioral symptoms were less common (HS 27% vs. LS 89%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.001). All HS patients had c\u2010NORSE, whereas 69% of the LS patients had other diagnoses, such as AE (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098), herpes simplex virus encephalitis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094), paraneoplastic encephalomyelitis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091), acute disseminated encephalomyelitis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091), and other causes (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094). The sensitivity of the c\u2010NORSE score for predicting cryptogenic cases was 57.9% (95% confidence interval [CI] =\u200936%\u201380%), and the specificity was 100% (95% CI\u2009=\u200984%\u2013100%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>In this cohort, AE was the most identified cause of NORSE, and 51% were cryptogenic. c\u2010NORSE score \u2265\u20095 had a specificity of 100% (95% CI\u2009=\u200984%\u2013100%) for identifying cryptogenic cases, whereas a score &lt;\u20095 indicates additional investigation should be ordered. Although the sensitivity of the c\u2010NORSE score was lower than previously reported, suggesting it may vary depending on complementary investigation, it is a useful tool for bedside NORSE evaluation in low\u2010income countries, where access to antineuronal abs is limited.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/epi.18374","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T09:08:24Z","timestamp":1746176904000},"page":"2285-2294","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Performance of cryptogenic new onset refractory status epilepticus score in a Brazilian cohort after testing for antineuronal antibodies with tissue\u2010based and cell\u2010based assays"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5226-8354","authenticated-orcid":false,"given":"Jo\u00e3o Henrique Fregadolli","family":"Ferreira","sequence":"first","affiliation":[{"name":"Instituto do C\u00e9rebro, Hospital Israelita Albert Einstein  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Maria","family":"Gomes","sequence":"additional","affiliation":[{"name":"Instituto do C\u00e9rebro, Hospital Israelita Albert Einstein  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5668-7150","authenticated-orcid":false,"given":"Ana Carolina","family":"Zetehaku","sequence":"additional","affiliation":[{"name":"Instituto do C\u00e9rebro, Hospital Israelita Albert Einstein  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2971-3552","authenticated-orcid":false,"given":"Taissa Ferrari","family":"Marinho","sequence":"additional","affiliation":[{"name":"Instituto do C\u00e9rebro, Hospital Israelita Albert Einstein  S\u00e3o 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