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Subacute encephalopathy with seizures in alcoholics (SESA) syndrome: a subtype of focal non-convulsive status epilepticus

bmjcr · 2025-09-21 · canonical JSON source

3 visible annotations · policy: published · automated confidence ≥ 75.00%

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Focal status epilepticus is often associated with intracranial infections, neoplasms or vascular aetiologies. Subacute encephalopathy with seizures in alcoholics (SESA) syndrome is a clinically under-recognised disorder characterised by encephalopathy in the context of seizure and specific focal EEG abnormalities. Our case involved a male in his 50s with a history of alcohol use disorder, who presented with left-sided twitching and encephalopathy, found to be in a focal status. An EEG revealed abnormal discharges in the right frontoparietal region. MRI of the brain displayed signal changes in the right cerebral hemisphere, hippocampus and thalamus. A fluorodeoxyglucose positron emission tomography showed hypometabolism in the bilateral cerebral cortices. The final diagnosis of SESA was made after a comprehensive evaluation. The patient improved in both his symptoms and interval MRI after initiation of appropriate anti-seizure medications.