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Consensus-based recommendations for the management of new-onset refractory status epilepticus/febrile infection-related epilepsy syndrome

Overall, 85 recommendation statements achieved consensus. The recommendations are divided into five sections: (1) disease characteristics; (2) diagnostic testing and sampling; (3) acute treatment; (4) treatment in the post-acute phase; and (5) research, registries, and future directions in NORSE/FIRES. These are summarized in this article along with two practical clinical flowsheets: one for diagnosis and evaluation and one for acute treatment. A corresponding evidence-based analysis of all 85 recommendations alongside responses by the Delphi panel is presented in a companion article.


AE, autoimmune encephalitis; ASM, anti-seizure medication; FIRES, febrile infection-related epilepsy syndrome IV, intravenous; IVIG, intravenous immunoglobulins; NORSE, new-onset refractory status epilepticus RSE, refractory status epilepticus; SE, status epilepticus


  1. Wickstrom R, Taraschenko O, Dilena R, Payne ET, Specchio N, Nabbout R, et al. International consensus recommendations for management of new onset refractory status epilepticus (NORSE) including febrile infection-related epilepsy syndrome (FIRES): summary and clinical tools. Epilepsia. 2022 Aug 11;63(11):2827–2839. Available at: