New onset refractory status epilepticus diagnosed in the second trimester: A case report
Bibliographic record
Abstract
New-onset refractory status epilepticus (NORSE) is a rare condition in which a previously healthy individual develops refractory seizures without an identifiable cause. In pregnancy, management is particularly challenging due to the need to control seizures while minimizing teratogenic risk for the fetus. We report a 22-year-old woman who developed NORSE at 19 weeks' gestation following recurrent tonic-clonic seizures. Treatment included multiple antiseizure medications: levetiracetam, oxcarbazepine, lacosamide, clobazam, and lamotrigine. Due to super-refractory status, she required intubation and sedation with propofol and midazolam and was extubated once seizure-free. Following a breakthrough seizure and suicide attempt, levetiracetam was replaced with brivaracetam. Fetal growth and biophysical profile remained appropriate on serial surveillance. She underwent term induction of labor, delivering a healthy neonate without signs of withdrawal. This is the first reported case of second-trimester NORSE with favorable perinatal outcomes, underscoring the need for a multidisciplinary approach to balance seizure control and fetal safety.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.004 |
| 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".