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Patients With SESA Syndrome May Not Have a Good Outcome: A Case Series.

Jovana Ivanovic¹, Masa Kovacevic^1,2, Tamara Svabic Medjedovic^1,2

¹Neurology Clinic, University Clinical Center of Serbia, Belgrade, Serbia, kcs.ac.rs.

Case Reports in Medicine

|December 22, 2025

Summary

Subacute encephalopathy with seizures in alcoholics (SESA) is a rare but serious condition. Early recognition and treatment are crucial for managing this neurological complication of chronic alcohol abuse.

Keywords:

SESA alcohol encephalopathy epilepsy

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Area of Science:

Neurology
Toxicology
Internal Medicine

Background:

Subacute encephalopathy with seizures in alcoholics (SESA) is a rare complication of chronic alcohol abuse.
It presents with seizures, altered mental state, and focal neurological deficits.
Diagnostic findings include focal epileptic anomalies on EEG and reversible T2w/FLAIR hyperintense lesions on MRI.

Purpose of the Study:

To report on four male patients diagnosed with SESA.
To describe their clinical presentation, treatment, and outcomes.
To highlight the underrecognized nature and potential severity of SESA.

Main Methods:

Case series reporting on four male patients with SESA.
Patients presented with focal motor seizures or status epilepticus.
Treatment involved antiseizure polytherapy and intensive symptomatic therapies.

Main Results:

Two patients experienced a good outcome with no recurrent seizures.
Two patients developed multiorgan dysfunction and had a fatal outcome despite intensive care.
Outcomes were variable, ranging from recovery to fatality.

Conclusions:

SESA is a life-threatening neurological condition associated with chronic alcohol abuse.
The outcome of SESA is uncertain and can be fatal, particularly if ICU admission is required.
Prompt recognition and management are critical for patients with SESA.