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Cryptogenic new‐onset refractory status epilepticus (NORSE) following blood transfusion in a patient with severe anemia
Author(s) -
Wu Connie K.,
Culbertson Collin J.,
Von Stein Erica L.,
Walia Sandeep,
Krishnamohan Prashanth,
Threlkeld Zachary D.
Publication year - 2021
Publication title -
epileptic disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.673
H-Index - 53
eISSN - 1950-6945
pISSN - 1294-9361
DOI - 10.1684/epd.2021.1267
Subject(s) - medicine , status epilepticus , blood transfusion , refractory (planetary science) , anemia , posterior reversible encephalopathy syndrome , pediatrics , anesthesia , encephalopathy , surgery , epilepsy , magnetic resonance imaging , radiology , physics , psychiatry , astrobiology
New-onset refractory status epilepticus (NORSE) is a rare neurological emergency in which a patient without prior seizure disorder develops seemingly unprovoked status epilepticus refractory to treatment. We report the case of a middle-aged woman who developed NORSE after receiving multiple blood transfusions for subacute blood loss anemia secondary to menorrhagia. Although the mechanism is unclear, we propose that sudden changes in blood viscosity and vasogenic tone resulted in cortical edema and irritation. Although seizures have been documented in patients who undergo blood transfusion and develop posterior reversible encephalopathy syndrome (PRES), there was no radiographic evidence of PRES in this case. This is the first reported case of cryptogenic NORSE following blood transfusion.