Annals of Indian Academy of Neurology
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Year : 2019  |  Volume : 22  |  Issue : 2  |  Page : 210-212

Rare complication of carotid stenting: New-onset refractory status epilepticus: A study of five patients

1 Department of Neurology, Bombay Hospital and Institute of Medical Sciences, Mumbai, Maharashtra, India
2 Department of Neurology, Fortis Hospital, Mumbai, Maharashtra, India
3 Department of Intervention Neurology and Endovascular Neurosurgery, Breach Candy Trust Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Dr. Satish V Khadilkar
Room No 110, New Wing, First Floor, Bombay Hospital, New Marine Lines, Mumbai - 400 020, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aian.AIAN_445_18

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Introduction: New-onset refractory status epilepticus (NORSE) is uncommon and almost 50% of cases are cryptogenic. We report the rare development of NORSE following carotid artery stenting (CAS), a procedure which is increasingly being used to treat the carotid stenosis. Materials and Methods: Patients who developed NORSE following CAS for the prevention of stroke over a period of 5 years were analyzed retrospectively. The degree of internal carotid artery stenosis (ICA) was estimated as per the NASCET criteria. Results: We analyzed five patients (age: 56–83 years). NORSE was reported within 30 min to 14 days post-CAS. Status epilepticus was focal in two patients, generalized in two, and one had nonconvulsive status epilepticus. All patients were treated with multiple antiepileptic drugs. Four patients recovered and survived and one succumbed. Two patients had comorbid hypertension and two had diabetes and hypertension. Four patients had hemiparesis due to the contralateral middle cerebral artery territory infarction and one patient had syncope. Two patients had postinfarction gliosis. Conclusions: We report a new cause of NORSE, following CAS. Stroke resulting in gliosis and cerebral hyperperfusion syndrome are the proposed mechanisms.

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