TY - JOUR
T1 - International consensus recommendations for management of new onset refractory status epilepticus including febrile infection-related epilepsy syndrome
T2 - Statements and supporting evidence
AU - the International NORSE Consensus Group
AU - Wickstrom, Ronny
AU - Taraschenko, Olga
AU - Dilena, Robertino
AU - Payne, Eric T.
AU - Specchio, Nicola
AU - Nabbout, Rima
AU - Koh, Sookyong
AU - Gaspard, Nicolas
AU - Hirsch, Lawrence J.
AU - Auvin, Stephane
AU - van Baalen, Andreas
AU - Beghi, Ettore
AU - Benseler, Susanne M.
AU - Bergin, Peter
AU - Bleck, Tom
AU - Brunklaus, Andreas
AU - Caraballo, Roberto H.
AU - Cervenka, Mackenzie
AU - Costello, Daniel
AU - Drislane, Frank
AU - Farias-Moeller, Raquel
AU - Gallantine, William
AU - Gilmore, Emily
AU - Gofton, Teneille
AU - Jimenez, Maria Angeles Perez
AU - Hocker, Sara
AU - Kaliakatsos, Marios
AU - Kellogg, Marissa
AU - Lee, Jong Woo
AU - Loddenkemper, Tobias
AU - Meletti, Stefano
AU - Mizugushi, Masashi
AU - Muscal, Eyal
AU - Riviello, James J.
AU - Rosenthal, Eric S.
AU - Rossetti, Andrea O.
AU - Ruegg, Stefan
AU - Said, Rana
AU - Sculier, Claudine
AU - Schmitt, Sarah
AU - Schuele, Stephan
AU - Stredny, Coral
AU - Trinka, Eugen
AU - Wainwright, Mark
AU - VanHaerents, Stephen
AU - Wells, Elisabeth
AU - Wirrell, Elaine
AU - Zuberi, Sameer M.
N1 - Publisher Copyright:
© 2022 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.
PY - 2022/11
Y1 - 2022/11
N2 - Objective: This study was undertaken to develop consensus-based recommendations for the management of adult and pediatric patients with new onset refractory status epilepticus (NORSE)/febrile infection-related epilepsy syndrome (FIRES) based on best evidence and experience. Methods: The Delphi methodology was followed. A facilitator group of nine experts was established, who defined the scope, users, and suggestions for recommendations. Following a review of the current literature, recommendation statements concerning diagnosis, treatment, and research directions were generated, which were then rated on a scale of 1 (strongly disagree) to 9 (strongly agree) by a panel of 48 experts in the field. Consensus that a statement was appropriate was reached if the median score was ≥7 and inappropriate if the median score was ≤3. The analysis of evidence was mapped to the results of each statement included in the Delphi survey. Results: Overall, 85 recommendation statements achieved consensus. The recommendations are divided into five sections: (1) disease characteristics; (2) diagnostic testing and sampling; (3) acute treatment; (4) treatment in the postacute phase; and (5) research, registries, and future directions in NORSE/FIRES. The detailed results and discussion of all 85 statements are outlined herein. A corresponding summary of findings and practical flowsheets are presented in a companion article. Significance: This detailed analysis offers insight into the supporting evidence and the current gaps in the literature that are associated with expert consensus statements related to NORSE/FIRES. The recommendations generated by this consensus can be used as a guide for the diagnosis, evaluation, and management of patients with NORSE/FIRES, and for planning of future research.
AB - Objective: This study was undertaken to develop consensus-based recommendations for the management of adult and pediatric patients with new onset refractory status epilepticus (NORSE)/febrile infection-related epilepsy syndrome (FIRES) based on best evidence and experience. Methods: The Delphi methodology was followed. A facilitator group of nine experts was established, who defined the scope, users, and suggestions for recommendations. Following a review of the current literature, recommendation statements concerning diagnosis, treatment, and research directions were generated, which were then rated on a scale of 1 (strongly disagree) to 9 (strongly agree) by a panel of 48 experts in the field. Consensus that a statement was appropriate was reached if the median score was ≥7 and inappropriate if the median score was ≤3. The analysis of evidence was mapped to the results of each statement included in the Delphi survey. Results: Overall, 85 recommendation statements achieved consensus. The recommendations are divided into five sections: (1) disease characteristics; (2) diagnostic testing and sampling; (3) acute treatment; (4) treatment in the postacute phase; and (5) research, registries, and future directions in NORSE/FIRES. The detailed results and discussion of all 85 statements are outlined herein. A corresponding summary of findings and practical flowsheets are presented in a companion article. Significance: This detailed analysis offers insight into the supporting evidence and the current gaps in the literature that are associated with expert consensus statements related to NORSE/FIRES. The recommendations generated by this consensus can be used as a guide for the diagnosis, evaluation, and management of patients with NORSE/FIRES, and for planning of future research.
KW - Delphi
KW - adult
KW - antiseizure medication
KW - epilepsy
KW - immunotherapy
KW - ketogenic diet
KW - pediatric
KW - refractory status epilepticus
KW - status epilepticus
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U2 - 10.1111/epi.17397
DO - 10.1111/epi.17397
M3 - Article
C2 - 35997591
AN - SCOPUS:85138882054
SN - 0013-9580
VL - 63
SP - 2840
EP - 2864
JO - Epilepsia
JF - Epilepsia
IS - 11
ER -