International consensus recommendations for management of New Onset Refractory Status Epilepticus (NORSE) incl. Febrile Infection-Related Epilepsy Syndrome (FIRES): Statements and Supporting Evidence.
International consensus recommendations for management of New Onset Refractory Status Epilepticus (NORSE) incl. Febrile Infection-Related Epilepsy Syndrome (FIRES): Statements and Supporting Evidence.
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本研究旨在根据最佳证据和经验，为新发难治性癫痫持续状态（NORSE）/发热性感染相关癫痫综合征（FIRES）成人和儿童患者的管理制定基于共识的建议。采用了德尔菲法。成立了一个由9名专家组成的主持人小组，由他们确定建议的范围、用户和意见。在对现有文献进行回顾后，生成了关于诊断、治疗和研究方向的建议声明，然后由该领域的48名专家组成的小组在1（强烈不同意）至9（强烈同意）的量表上进行评分。一致认为，如果中位分≥7，则声明是适当的，如果中位分≤3，则声明是不适当的。证据分析与德尔菲调查中的每个陈述的结果相对应。总体而言，85项建议声明达成了共识。建议分为五个部分：（1）疾病特征;（2）诊断测试和采样;（3）急性治疗;（4）急性期后的治疗;（5）研究，登记和未来的方向在NORSE/FIRES。本文概述了所有85份声明的详细结果和讨论。相应的研究结果和实际流程的总结在配套文章中介绍。这种详细的分析提供了对支持证据的深入了解，以及与NORSE/FIRES相关的专家共识声明相关的文献中的当前差距。该共识产生的建议可用作NORSE/FIRES患者诊断、评估和管理的指南，以及未来研究的规划。
This study was undertaken to develop consensus‐based recommendations for the management of adult and pediatric patients with new onset refractory status epilepticus (NORSE)/febrile infection‐related epilepsy syndrome (FIRES) based on best evidence and experience. The Delphi methodology was followed. A facilitator group of nine experts was established, who defined the scope, users, and suggestions for recommendations. Following a review of the current literature, recommendation statements concerning diagnosis, treatment, and research directions were generated, which were then rated on a scale of 1 (strongly disagree) to 9 (strongly agree) by a panel of 48 experts in the field. Consensus that a statement was appropriate was reached if the median score was ≥7 and inappropriate if the median score was ≤3. The analysis of evidence was mapped to the results of each statement included in the Delphi survey. 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 postacute phase; and (5) research, registries, and future directions in NORSE/FIRES. The detailed results and discussion of all 85 statements are outlined herein. A corresponding summary of findings and practical flowsheets are presented in a companion article. This detailed analysis offers insight into the supporting evidence and the current gaps in the literature that are associated with expert consensus statements related to NORSE/FIRES. The recommendations generated by this consensus can be used as a guide for the diagnosis, evaluation, and management of patients with NORSE/FIRES, and for planning of future research.
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3.3
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