{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T07:02:17Z","timestamp":1780297337382,"version":"3.54.0"},"reference-count":16,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Neurohospitalist"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>\n                    <jats:bold>Introduction:<\/jats:bold>\n                    New Onset Refractory Status Epilepticus (NORSE) occurs without an acute structural, toxic, or metabolic cause in individuals without known epilepsy or a related neurological disease. In about 50% of cases, NORSE is attributed to autoimmune or viral encephalitis; in the rest, it remains cryptogenic, posing significant treatment challenges and high risks of mortality and long-term neurological issues. Standard management often involves multiple antiseizure medications, and immunosuppressive therapies used even when an autoimmune cause is unproven.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Case Description:<\/jats:bold>\n                    We report a 23-year-old woman with cryptogenic NORSE resistant to multiple antiseizure medications, intravenous anesthetics, and immunosuppression, requiring a 5-month barbiturate-induced coma. Attempts to reduce anesthetics triggered recurrent super-refractory status epilepticus. Extensive working up including neuroimaging, cerebrospinal fluid, and autoimmune testing revealed no clear etiology. High-dose steroids, IVIG, plasmapheresis, rituximab, tocilizumab, and anakinra were ineffective. An FDA authorization for emergency single-patient IND (eIND) approval allowed treatment with IV ganaxolone, a GABA\n                    <jats:sub>A<\/jats:sub>\n                    receptor modulator, which was used alongside electroconvulsive therapy. Nine days after initiation of ganaxolone and 13 days after ECT was started, pentobarbital was successfully tapered, and seizures ceased. Consciousness and near-normal language function returned gradually, with residual cognitive deficits. After an 8-month hospitalization, she was discharged to inpatient rehabilitation and subsequently home. At 6 months post-discharge, her Glasgow Outcome Scale\u2013Extended Score was 7.\n                  <\/jats:p>","DOI":"10.1177\/19418744251395578","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T22:26:58Z","timestamp":1762468018000},"page":"238-244","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Successful Treatment of Cryptogenic NORSE Resistant to Immunosuppression With Intravenous Ganaxolone and Electroconvulsive Therapy"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0022-6571","authenticated-orcid":false,"given":"Zheng D.","family":"Lan","sequence":"first","affiliation":[{"name":"Montefiore Medical Center"},{"name":"Montefiore Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishi","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Montefiore Medical Center"},{"name":"Montefiore Medical Center"},{"name":"Montefiore Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Naqvi","sequence":"additional","affiliation":[{"name":"Montefiore Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7696-1540","authenticated-orcid":false,"given":"Megan","family":"Barra","sequence":"additional","affiliation":[{"name":"Marinus Pharmaceuticals, Inc"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henri","family":"Vaitkevicius","sequence":"additional","affiliation":[{"name":"Marinus Pharmaceuticals, Inc"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1291-6257","authenticated-orcid":false,"given":"Ibrahim","family":"Migdady","sequence":"additional","affiliation":[{"name":"University of Texas Health Science Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,6]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.14022"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.14016"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2018.09.018"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17523"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13837"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17397"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.51229"},{"key":"e_1_3_7_9_2","first-page":"100431","article-title":"Resolution of cryptogenic new onset refractory status epilepticus with tocilizumab epilepsy","volume":"15","author":"Donnelly JP","year":"2021","unstructured":"Donnelly JP, Kasatwar N, Hafeez S, et al. Resolution of cryptogenic new onset refractory status epilepticus with tocilizumab epilepsy. Behav Rep. 2021;15:100431.","journal-title":"Behav Rep"},{"key":"e_1_3_7_10_2","first-page":"5843089","article-title":"Rituximab for autoimmune encephalitis with epilepsy case","volume":"2020","author":"Kurukumbi M","year":"2020","unstructured":"Kurukumbi M, Dave RH, Castillo J, Shah T, Lau J. Rituximab for autoimmune encephalitis with epilepsy case. Rep Neurol Med. 2020;2020:5843089.","journal-title":"Rep Neurol Med"},{"key":"e_1_3_7_11_2","first-page":"39","article-title":"ECT and grand mal epilepsy convuls","volume":"8","author":"Viparelli U","year":"1992","unstructured":"Viparelli U, Viparelli G. ECT and grand mal epilepsy convuls. Ther. 1992;8:39-42.","journal-title":"Ther"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.18432"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25008"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(22)00077-1"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17343"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/epi4.12669"},{"key":"e_1_3_7_17_2","unstructured":"Marinus pharmaceuticals announces topline results from phase 3 RAISE trial of IV ganaxolone in refractory status Epilepticus2024. https:\/\/ir.marinuspharma.com\/news\/news-details\/2024\/Marinus-Pharmaceuticals-Announces-Topline-Results-from-Phase-3-RAISE-Trial-of-IV-Ganaxolone-in-Refractory-Status-Epilepticus\/default.aspx"}],"container-title":["The Neurohospitalist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19418744251395578","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/19418744251395578","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19418744251395578","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T06:22:54Z","timestamp":1780294974000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/19418744251395578"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,6]]},"references-count":16,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1177\/19418744251395578"],"URL":"https:\/\/doi.org\/10.1177\/19418744251395578","relation":{},"ISSN":["1941-8744","1941-8752"],"issn-type":[{"value":"1941-8744","type":"print"},{"value":"1941-8752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,6]]}}}