Review and standard operating procedures for collection of biospecimens and analysis of biomarkers in new onset refractory status epilepticus

Aurélie Hanin, Jorge Cespedes, Yashwanth Pulluru, Margaret Gopaul, Eleonora Aronica, Danielle Decampo, Ingo Helbig, Charles L. Howe, Anita Huttner, Sookyong Koh, Vincent Navarro, Olga Taraschenko, Annamaria Vezzani, Michael R. Wilson, Julie Xian, Nicolas Gaspard, Lawrence J. Hirsch

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


New onset refractory status epilepticus (NORSE), including its subtype with a preceding febrile illness known as febrile infection-related epilepsy syndrome (FIRES), is one of the most severe forms of status epilepticus. The exact causes of NORSE are currently unknown, and there is so far no disease-specific therapy. Identifying the underlying pathophysiology and discovering specific biomarkers, whether immunologic, infectious, genetic, or other, may help physicians in the management of patients with NORSE. A broad spectrum of biomarkers has been proposed for status epilepticus patients, some of which were evaluated for patients with NORSE. Nonetheless, none has been validated, due to significant variabilities in study cohorts, collected biospecimens, applied analytical methods, and defined outcome endpoints, and to small sample sizes. The NORSE Institute established an open NORSE/FIRES biorepository for health-related data and biological samples allowing the collection of biospecimens worldwide, promoting multicenter research and sharing of data and specimens. Here, we suggest standard operating procedures for biospecimen collection and biobanking in this rare condition. We also propose criteria for the appropriate use of previously collected biospecimens. We predict that the widespread use of standardized procedures will reduce heterogeneity, facilitate the future identification of validated biomarkers for NORSE, and provide a better understanding of the pathophysiology and best clinical management for these patients.

Original languageEnglish (US)
Pages (from-to)1444-1457
Number of pages14
Issue number6
StatePublished - Jun 2023


  • biomarkers
  • biospecimens
  • new onset refractory status epilepticus
  • standard operating procedures

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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