Subacute Encephalopathy With Seizures in Alcoholics (SESA) Presenting as Focal Nonconvulsive Status Epilepticus

Area of Science:

• Neurology
• Neurophysiology
• Neuroradiology

Background:

• Subacute encephalopathy with seizures in chronic alcoholics (SESA) is an underrecognized neurological condition.
• SESA has been increasingly associated with various forms of status epilepticus, including nonconvulsive status epilepticus (NCSE).

Observation:

• This study presents two cases of SESA.
• One case exhibited alternating bifrontoparietal NCSE, while the other presented with focal, confusional NCSE.
• Both cases demonstrated characteristic imaging and electroencephalogram (EEG) findings.

Findings:

• SESA can present as NCSE, characterized by focal clinical symptoms, EEG abnormalities, and reversible diffusion-weighted MRI findings.
• The observed abnormalities on MRI were reversible, suggesting a dynamic pathological process.

Implications:

• Expedited diagnosis of SESA presenting as NCSE is essential.
• Prompt initiation of antiseizure treatment is critical to minimize neurological morbidity in affected individuals.
• Recognition of SESA as a potential cause of NCSE can improve patient outcomes.