Concurrent non-invasive neuromodulation therapies in new-onset super refractory status epilepticus

Abstract

Abstract Super-refractory status epilepticus (SRSE) is a severe neurological condition. We present a 32-year-old woman with SRSE secondary to N-methyl-D-aspartate receptor autoimmune encephalitis. She received simultaneous cathodal transcranial direct current stimulation over the right frontocentral ictal region and the Mozart effect using a smartphone. Pre- and post-intervention EEG recordings were conducted. Following the interventions, ictal epileptiform activity vanished, halting seizures, albeit with persistent encephalopathy. Sadly, SRSE re-emerged, successfully treated thrice, but the patient succumbed to sepsis. This unique approach signifies the first evidence of c-tDCS and the Mozart effect offering transient EEG improvement in SRSE related to NMDAR encephalitis.