NEW-ONSET REFRACTORY STATUS EPILEPTICUS WITH RESTRICTED DWI AND NEURONOPHAGIA IN THE PULVINAR
Bibliographic record
Abstract
New-onset refractory status epilepticus (NORSE) is a recently defined clinical entity which describes patients who present with severe generalized seizures of unclear etiology that occur in the context of a preceding febrile illness.1–3 These seizures are typically unresponsive to antiepileptic medications. ### Case report. A 26-year-old otherwise healthy right-handed man presented with generalized tonic-clonic seizures after a 1-week history of headache, fever, and myalgias. He was admitted to our intensive care unit for treatment and underwent continuous EEG monitoring for 77 days. On admission to our intensive care unit, the CSF contained 92 × 106 white blood cells (96% lymphocytes). Consistent with previous reports of NORSE, an exhaustive structural, infectious, toxic/metabolic, autoimmune, neoplastic, and paraneoplastic workup did not identify a clear underlying etiology (figure, A). IV infusions of propofol or thiopental were used to maintain the patient in either an electrographic burst suppression pattern or electrographic silence, while enteral antiepileptic medications were titrated to therapeutic doses (e.g., phenytoin, valproic acid, clobazam, topiramate, vigabatrin, phenobarbital, and levetiracetam) (figure, B). Attempts to wean IV antiepileptic drugs were met with recurrence of electrographic multifocal sharp transients, originating from either temporal lobe, which evolved into clinical and electrographic seizures. Figure Laboratory investigations, imaging, and pathologic findings in a case of new-onset refractory status epilepticus (A) Table of investigations performed to identify the underlying etiology of the …
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".