Abstract：
New-onset refractory status epilepticus (NORSE) is a devastating clinical condition that often leads to severe disability. Intrathecal dexamethasone (IT-DEX) has been reported to improve refractory status epilepticus. We present an 11-year-old female with anti-GAD 65 encephalitis presenting as NORSE who had minimal response to standard anti-seizure medications and first-line immunotherapies. The patient received 6 doses of IT-DEX in conjunction with rituximab which correlated with subsequent decreased neuroinflammation, reduced seizure burden and aided in weaning anesthetic infusions. Our case with literature review suggests IT-DEX may be utilized as an early intervention in those with refractory status epilepticus from various etiologies.
摘要：
新发难治性癫痫持续状态（NORSE）是一种破坏性的临床疾病，通常会导致严重的残疾。据报道，鞘内注射地塞米松（IT-DEX）可改善难治性癫痫持续状态。我们介绍了一名11岁的女性，患有抗GAD65脑炎，表现为NORSE，对标准抗癫痫药物和一线免疫疗法的反应最小。患者接受了6剂IT-DEX联合利妥昔单抗，这与随后减少的神经炎症相关。减轻癫痫发作负担，并有助于断奶麻醉输注。我们的文献综述表明，IT-DEX可用作各种病因难治性癫痫持续状态患者的早期干预措施。
