Abstracts

Evidence Of Acute Brain Injury During Cryptogenic NORSE Compared To Etiology-Defined Status Epilepticus

Abstract number : 1.536
Submission category : 2. Translational Research / 2C. Biomarkers
Year : 2025
Submission ID : 1290
Source : www.aesnet.org
Presentation date : 12/6/2025 12:00:00 AM
Published date :

Authors :
Stefano Meletti, PhD, MD – UNIMORE
Aurelie Hanin, PhD – Department of Neurology, Comprehensive Epilepsy Center, Yale University School of Medicine
Presenting Author: Margherita Burani, MD – University of Modena and Reggio-Emilia, Modena, italy,

Giada Giovannini, PhD, MD – Modena Academic Hospital, Italy
Niccolò Orlandi, MD – Modena Acadmeic Hospital, Italy
Roberta Bedin, PhD – UNIMORE, Italy
Lisa Taruffi, MD – University of Modena and Reggio Emilia, Italy
Stephen Hantus, MD – Cleveland Clinic
Krista Eschbach, MD – Children Hospital Colorado
Elizabeth Gerard, MD – Northwestern University
Hiba Haider, MD – Department of Neurology, University of Chicago, IL
Sara Hocker, MD – Mayo Clinic
Ji Yeoun Yoo, MD – Icahn School of Medicine at Mount Sinai, New York City
Claude Steriade, MD – Department of Neurology, NYU Langone Medical Center, New York City
Mark Wainwright, MD – Division of Pediatric Neurology, Seattle Children’s Hospital, University of Washington, Seattle
Brandon Foreman, MD – Division of Neurocritical Care, Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH
Susan Hermann, MD – Barrow Neurological Institute
Raquel Farias-Moeller, MD – Medical College Wisconsin
Daniel Zhou, MD – University of Pennsylvania, Philadelphia, PA
Padmaja Kandula, MD – Weill Cornell Medicine, Department of Neurology, New York City
Maysaa Basha, MD – Wayne State University School of Medicine, Detroit, MI
Olga Taraschenko, MD – Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE
Aaron Struck, MD – University of Wisconsin, Department of Neurology, Madison, WI
Peter Kang, MD – Washington Saint-Louis
Simona Lattanzi, MD, PhD – Neurology Dept, Università Politecnica delle Marche, Ancona, Italy
Nicolas Gaspard, MD – Department of Neurology, Hopital Universitaire de Bruxelles–Hopital Erasme, Universite Libre de Bruxelles, Belgium
Teneille Gofton, MD – Schulich School of Medicine and Dentistry, Western University, London Health Sciences Center, Ontario, Canada
Vincent Navarro, MD – Epilepsy Unit and Department of Clinical Neurophysiology, APHP, Hopital de la Pitie-Salpetrere, Sorbonne Universite, ERN-Epicare, Paris, France
Lawrence Hirsch, MD – Yale University School of Medicine

Rationale: We aimed to assess evidence of acute brain injury in patients with new-onset refractory status epilepticus (NORSE) and to compare injury biomarker profiles between NORSE and etiology-defined status epilepticus (eSE).

Methods: Serum and cerebrospinal fluid (CSF) concentrations of neurofilament light chain (NfL) and S100B protein were measured in: 93 NORSE cases from the Yale biorepository (mean age 36 years; 55% female), 211 eSE cases (mean age 69 years; 61% female), 36 patients with chronic epilepsy (mean age 37 years; 52% female), and 30 healthy controls (mean age 40 years; 50% female) from the Modena NeuroBioBank. Fever preceded SE in 62% of NORSE cases, and 87% remained cryptogenic (cNORSE). Among eSE cases, 48% presented with refractory SE (eRSE) and 11% with super-refractory SE (eSRSE).

Results: In cNORSE, NfL concentrations were markedly elevated—approximately sevenfold higher in CSF and fourfold higher in serum compared with eSE (p < 0.0001). Compared with non-SE controls, cNORSE NfL increases exceeded 15-fold in both serum and CSF. Secondary analyses comparing serum NfL in cNORSE to eRSE (n = 101), eSRSE (n = 23), and eSE of remote etiologies (n = 36) confirmed the primary findings. Serum and CSF NfL values were strongly correlated (Spearman’s ρ = 0.747, p < 0.001). NfL levels rose sharply from week 1 to week 2 after cNORSE onset (p < 0.001) before reaching a plateau.
Translational Research