SUPER-REFRACTORY STATUS EPILEPTICUS – A RARE PRESENTATION OF PML

Progressive multifocal leukoencephalopathy (PML) presents in the setting of a poor immunological status expressed by a low CD4 cell count (< 200/µL). Very few reports have described of PML in HIV-infected patients in the setting of better immunological function (i.e. CD4 counts >500/µL).1 PML can occur in setting of CD4 Count more than 200 reason being high CSF viral load and ART failure. Although seizures have been considered a rare manifestation of PML, seizures can occur in up to 18% of PML patients2. In minority of patients PML can actually be revealed by new onset seizures. Seizures usually respond well to treatment and do not affect survival. Very rarely patient can present as resistant status epilepticus3 or epilepsia partialis continua4. we present a case were PML is manifested as super refractory status epilepticus in a patient with CD count >200 /µl.