{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:38:29Z","timestamp":1787017109432,"version":"build-2736575974"},"reference-count":11,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T00:00:00Z","timestamp":1724803200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2024,8,3]]},"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:p>A 21-year-old woman developed explosive new-onset refractory status epilepticus when 18 weeks pregnant. She had been previously well with no history of seizures and a normal developmental history. She had initially presented with focal impaired awareness seizures but subsequently developed status epilepticus requiring intensive care unit admission and was successfully treated with multiple anti-seizure medications. Once stabilised she was stepped down to the inpatient neurology ward and then transferred to the tertiary centre for a planned late termination of pregnancy, which was the patient\u2019s choice. Following transfer, she again developed refractory status epilepticus, requiring intensive care readmission. Subsequent investigations identified a compound heterozygous POLG genetic mutation. We discuss the challenges in the acute clinical situation and important considerations in the diagnosis and management of POLG-related epilepsy.<\/jats:p>","DOI":"10.1136\/pn-2024-004232","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T00:30:10Z","timestamp":1724891410000},"page":"56-59","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["POLG epilepsy presenting as new-onset refractory status epilepticus (NORSE) in pregnancy"],"prefix":"10.1136","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4850-6791","authenticated-orcid":false,"given":"Viva","family":"Levee","sequence":"first","affiliation":[{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthikeyan","family":"Sivaganesh","sequence":"additional","affiliation":[{"name":"Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Schaeffer","sequence":"additional","affiliation":[{"name":"NHS Highly Specialised Service for Rare Mitochondrial Disorders, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK"},{"name":"Translational and Clinical Research Institute, Mitochondrial Research Group, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kushan","family":"Karunaratne","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust, London, 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