Reader response: New onset refractory status epilepticus research: What is on the horizon?

I read with interest the Contemporary Issues article by Gofton et al.1 on new-onset refractory status epilepticus (NORSE).Treatment for patients with NORSE includes traditional anticonvulsant therapy and intravenous anesthetic for status epilepticus. In addition, many patients are administered with immunotherapies, such as IV methylprednisolone, IV immunoglobulin, plasma exchange, rituximab, or cyclophosphamide. Autoantibodies-induced cases of NORSE may respond to immunogenic therapy, but—at the onset of NORSE—many of these autoantibodies are not readily detectable, and it may take weeks for the results to come back. Do the authors have any recommendation on which patients with NORSE should be immediately treated with immune modulators? In addition, are there any data for treatment of NORSE with allopregnanolone?

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