Understanding new-onset refractory status epilepticus from an immunological point of view

New-onset refractory status epilepticus (NORSE) is unexpected onset of in individuals with no preexisting relevant neurologic condition. The etiologies remain largely cryptogenic; treatment challenging after failure to control seizures despite use multiple antiepileptic drugs and anesthetic agents. Frequent fever other infectious prodromes, elevated proinflammatory cytokine/chemokine levels, limbic or multifocal brain lesions indicate active inflammation NORSE. Among identified causes, autoimmune encephalitis the most common accounts for more than one-third all known NORSE cases, followed by infection-related etiologies. Although evidence needed, anti-cytokine therapies tocilizumab anakinra along immunotherapeutic agents used can aid alleviating hindering inflammatory cascade controlling seizures. Keywords: epilepticus, Etiology, Autoimmune, Inflammation, Cryptogenic