PT - JOURNAL ARTICLE AU - Mehboob, Sadaf AU - Sureshkumar, Soorya Mukkadayil AU - Fernandes, Linford AU - Wright, Elizabeth AU - Ray, Munni AU - Goodden, John AU - Maguire, Melissa TI - Refractory status epilepticus arrested by vagus nerve stimulation AID - 10.1136/pn-2023-003896 DP - 2024 Apr 01 TA - Practical Neurology PG - 129--133 VI - 24 IP - 2 4099 - http://pn.bmj.com/content/24/2/129.short 4100 - http://pn.bmj.com/content/24/2/129.full SO - Pract Neurol2024 Apr 01; 24 AB - A 54-year-old man developed altered mental state and generalised tonic-clonic seizures after 1 week of upper respiratory tract symptoms and diarrhoea, having been previously well. His MR scan of brain showed multifocal progressive T2 cortical signal changes. He was diagnosed with new-onset refractory status epilepticus (NORSE), initially treated as being secondary to autoimmune/paraneoplastic limbic encephalitis, although subsequent investigations were negative. His seizures and electrographic epileptiform activity continued despite escalating doses of antiseizure medications, immunosuppression with corticosteroids, immunoglobulins, plasma exchange and rituximab, and thereafter anaesthetic agents. A vagus nerve stimulator (VNS) was implanted 6 weeks after admission and its voltage rapidly increased over 4 days; his seizure activity resolved in the third week after VNS implantation. This case highlights the role of VNS in the early management of NORSE.Data sharing not applicable as no datasets generated and/or analysed for this study. All data relevant to the study are included in the article or uploaded as supplementary information.