Claustrum Involvement in New Onset Refractory Status Epilepticus: A Systematic Review.

Of 785 records identified, 65 studies met inclusion criteria; 41 provided individual patient data, yielding 206 new-onset refractory status epilepticus cases (72 with the claustrum sign, 134 without).

Convulsive status epilepticus (SE) occurred in 98%, progressing to super-refractory SE (super-refractory SE) in more than half reported cases.

Bilateral claustrum hyperintensity was detected in 68/71 patients during the acute phase, typically emerging 7 days after SE onset.

In-hospital mortality was 9%, while 74% of patients developed chronic epilepsy.