Seasonality in New-onset Refractory Status Epilepticus (NORSE)
Abstract number :
2.379
Submission category :
16. Epidemiology
Year :
2022
Submission ID :
2204977
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:27 AM
Authors :
Margaret Gopaul, PhD, MSCP – Yale University; Jorge Cespedes, BHSc – Yale University; Yashwanth Pulluru, MD – University of Nebraska Medical Center; Karnig Kazazian, BSc (Ph.D. candidate) – Western Institute of Neuroscience – Western University; Teneille Gofton, MD FRCPC – Clinical Neurological Sciences – Schulich School of Medicine and Dentistry; Nicolas Gaspard, MD – Département de Neurologie – Université Libre de Bruxelles, Hôpital Erasme; Aurélie Hanin, PharmD, PhD - Yale University; Lawrence Hirsch, MD – Neurology, Comprehensive Epilepsy Center – Yale University University School of Medicine
Rationale: In recent years, the study of NORSE (including its subtype of FIRES) has increased (Lattanzi et al., 2022), but its cause remains uncertain in many cases. A seasonality of NORSE might suggest an infectious or para-infectious cause, but this has remained unexamined due to a lack of existing data. In this study, we thus investigated seasonality among patients with NORSE.
Methods: We combined three different datasets of NORSE patients, for a total of 216 cases, pediatric and adult. (1) NORSE Biorepository at Yale (clinical centers, most in the United States), n=50; (2) NORSE Family Registry (online-only data bank, international), n= 54; and (3) retrospective database from prior publication (Gaspard et al., Neurology 2015) (clinical centers in the United States and Europe), n= 112. A chi-square goodness-of-fit test was used to determine if there was any significant difference in the incidence of NORSE when grouped by month or season.
Results: Analysis by month:There was a peak incidence in March (n=24) and nadir in January (n=12) and April (n=12) (Figure 1A); however, there was no statistically significant difference in the incidence by month._x000D_
Analysis by season: There was a significant seasonal difference in the incidence of NORSE based on astronomical season, with the most cases in summer (n=70) and the least in spring (n=40) (Figure 1B); χ2 (3) = 8.04, p = .04.
Conclusions: These preliminary findings of seasonal patterns related to NORSE, with more cases presenting in the summer and fewer in the spring, serve as a catalyst for promoting further research to confirm or refute a seasonal link to NORSE. If confirmed, this might suggest particular etiologies, such as specific infections as triggers. Other variables such as geographical location and year (to look for “outbreaks”) should be considered as well in future studies.
References:_x000D_
1. Gaspard N, Foreman BP, Alvarez V, Cabrera Kang C, Probasco JC, Jongeling AC, Meyers E, Espinera A, Haas KF, Schmitt SE, Gerard EE, Gofton T, Kaplan PW, Lee JW, Legros B, Szaflarski JP, Westover BM, LaRoche SM, Hirsch LJ; Critical Care EEG Monitoring Research Consortium (CCEMRC). New-onset refractory dtatus epilepticus: etiology, clinical features, and outcome. Neurology. 2015;85(18):1604-1613. doi: 10.1212/WNL.0000000000001940_x000D_
2. Lattanzi S, Leitinger M, Rocchi C, Salvemini S, Matricardi S, Brigo F, Meletti S, Trinka E. Unraveling the enigma of new-onset refractory status epilepticus: a systematic review of aetiologies. Eur J Neurol. 2022;29(2):626-647. _x000D_
Funding: The NORSE Biorepository at Yale is generously supported by the Daniel Raymond Wong Neurology Research Fund. The NORSE Family Registry is generously supported by the Robert N. Kohn Memorial Research Fund.
Epidemiology