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Exploring pathways leading to drug-resistant epilepsy for patients with cryptogenic new onset refractory status epilepticus - PubMed

5 days ago
  • #biomarkers
  • #NORSE epilepsy
  • #neuroinflammation
  • Study focuses on cryptogenic new onset refractory status epilepticus (cNORSE) and its pathways to drug-resistant epilepsy.
  • Inflammatory and brain injury biomarkers were assessed for predictive value in cNORSE outcomes.
  • Elevated innate cytokines and brain injury biomarkers during cNORSE correlated with worse functional outcomes.
  • Serum neurofilament light chain (NfL) improved poor outcome prediction when added to cytokine models.
  • Post-cNORSE epilepsy was associated with prolonged status epilepticus, MRI abnormalities, and intensive treatment needs.
  • Most serum cytokines normalized in the chronic phase, but new adaptive immune disturbances appeared in 20% of patients.
  • Persistently elevated NfL levels were more frequent in post-cNORSE epilepsy, suggesting ongoing axonal injury.
  • Innate immune activation is acute in cNORSE but largely resolves, indicating it's not the driver of chronic epilepsy.
  • Persistent NfL elevation suggests ongoing axonal injury, contributing to poor outcomes.
  • Combining inflammatory and neuroaxonal injury biomarkers may improve risk stratification and long-term management.