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Refractory Status Epilepticus in a Patient With Aducanumab-Induced Amyloid-Related Imaging Abnormalities
Neves Briard J, Duquette A, Cayrol R, Lapalme-Remis S.. Neurology, 2024-08-09
Topic: Brain proteins, microglia and lab models
Objective To report a case of fatal super-refractory status epilepticus associated with amyloid-related imaging abnormalities (ARIA). Methods We describe the history, neuroimaging, EEG, and brain pathology findings of a 75-year-old patient with mild cognitive impairment due to Alzheimer disease (homozygous ε4 apolipoprotein status) and a remote history of 3 asymptomatic ARIA episodes, who developed super-refractory status epilepticus related to severe ARIA. Results The patient was participating in an extended open-label trial of aducanumab when she was admitted to hospital for focal seizures and ARIA in 2 noncontiguous regions of the left frontal and occipital lobes.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Neves Briard, J., Duquette, A., Cayrol, R., & Lapalme-Remis, S. (2024). Refractory Status Epilepticus in a Patient With Aducanumab-Induced Amyloid-Related Imaging Abnormalities. Neurology. https://doi.org/10.1212/wnl.0000000000209582
Vancouver
Neves Briard J, Duquette A, Cayrol R, Lapalme-Remis S. Refractory Status Epilepticus in a Patient With Aducanumab-Induced Amyloid-Related Imaging Abnormalities. Neurology. 2024. doi:10.1212/wnl.0000000000209582. PMID: 39121445.
BibTeX
@article{nevesbriard2024-39121445,
author = {Neves Briard, J. and Duquette, A. and Cayrol, R. and Lapalme-Remis, S.},
title = {{Refractory Status Epilepticus in a Patient With Aducanumab-Induced Amyloid-Related Imaging Abnormalities}},
journal = {Neurology},
year = {2024},
doi = {10.1212/wnl.0000000000209582},
pmid = {39121445},
url = {https://doi.org/10.1212/wnl.0000000000209582}
}
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Key findings
- Methods We describe the history, neuroimaging, EEG, and brain pathology findings of a 75-year-old patient with mild cognitive impairment due to Alzheimer disease (homozygous ε4 apolipoprotein status) and a remote history of 3 asymptomatic ARIA episodes, who developed super-refractory status epilepticus related to severe ARIA.
- Results The patient was participating in an extended open-label trial of aducanumab when she was admitted to hospital for focal seizures and ARIA in 2 noncontiguous regions of the left frontal and occipital lobes.
- Despite aggressive treatment with high-dose corticosteroids, sedation, and antiseizure medications, she died from refractory focal status epilepticus.
- In retrospect, routine surveillance brain magnetic resonance imaging performed 11 weeks before hospitalization had signs of ARIA, which had not been identified.
Why it matters
This case report describes a 75-year-old patient with mild cognitive impairment due to Alzheimer's disease who developed fatal super-refractory status epilepticus related to severe amyloid-related imaging abnormalities while in an extended open-label aducanumab trial. It reports a serious harm in a single patient, not a treatment, cure or prevention benefit.
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Study details
- Study designlongitudinal study
- Evidence strengthModerate
How this study scored 56/100
Published in a leading specialty journal, and it is a longitudinal study following the same people over time. Scored zero for sample size, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A longitudinal study following the same people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2024 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (pubmed indexes it as a clinical or observational study) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 3 / 7 | Cited 23 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 5.8 citations a year over 4 year(s) since 2024 |
| Impact for its field and year | 3 / 6 | Cited 5.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 4 other studies in this library |
| Still being cited | 2 / 4 | Cited 23 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Samuel Lapalme‐Remis: h-index 11 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Université de Montréal: institution h-index 1,020 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 39121445) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 56 / 100 | — |
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