Table 3.
Sr. no. | Variant | Definition and key features | Causes | Diagnosis | Treatment | Reference |
---|---|---|---|---|---|---|
(1) | SE | Seizure that persists for a significant period of time and occurs frequently is termed SE Exhibits high morbidity and low mortality rates |
Imbalance at cellular level pathways operating in CNS | EEG | Antiseizure drugs Anesthetic agents |
[3, 10, 14] |
| ||||||
(2) | RSE | SE which is incurable with two antiseizure drugs of which benzodiazepine is the one and the seizure lasts for around 1–2 hours Exhibits low mortality and high morbidity |
Duration of SE CNS infections Massive stroke Brain tumors |
Comprehensive metabolic profile Blood tests |
Combination of antiepileptic drugs Electroconvulsive therapy Recurrent transcranial magnetic stimulation (rTMS) |
[1, 3, 10, 22] |
| ||||||
(3) | SRSE | SE that continues up to 24 hours or more even after the use of anesthetic therapy Exhibits high mortality and morbidity |
Duration of SE CNS infections Metabolic disorders |
Cerebrospinal fluid tests Blood tests |
Immunomodulation therapies with immunoglobulins (IGs) and steroids Plasma exchange Epilepsy surgery |
[10, 26] |
| ||||||
(4) | NORSE | Occurs due to prolonged period of refractory seizures with no identifiable cause . Exhibits high mortality and morbidity |
Autoimmune disorders Unidentified viral infections |
Careful investigation of clinical history Continuous EEG monitoring Brain CT and MRI scan Cerebrospinal fluid tests Blood tests |
Newer analogs of antiseizure drugs Anesthetic agents |
[10, 24, 27] |
| ||||||
(5) | FIRES | Subjects experience a nonspecific febrile illness followed by the onset of seizure activity lasting around 1–2 weeks. Exhibits high mortality and morbidity |
Autoimmune paraneoplastic syndrome |
Careful investigation of clinical history Prolonged EEG Lumbar puncture Blood tests Genetic tests MRI |
Ketogenic diet Cannabidiol IGs (immunoglobulins) Monoclonal antibodies |
[10, 24, 25, 27] |