New-onset refractory status epilepticus after SARS-CoV-2 infection: a review of literature

Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily affects the respiratory system, neurological symptoms were reported both during acute and post-acute COVID-19. Notably, patients with no history of epilepsy or other neurological conditions developed new-onset refractory status epilepticus (NORSE) weeks, months, or even up to a year following the viral infection. While NORSE is uncommon, it carries a high mortality rate and can result in permanent epilepsy. Therefore, clinicians should consider the possibility of death or epilepsy development when treating individuals with NORSE who have recently contracted SARS-CoV-2. This article compiles comprehensive information on the mechanisms of epileptogenesis linked to SARS-CoV-2, the diagnosis of NORSE syndrome, its treatment options, and associated outcomes. Our aim was to enhance physicians' understanding of the virus's pathogenesis and increase the awareness of NORSE.