New Onset Refractory Status Epilepticus in an Adult Patient with Autoimmune Encephalitis Responding to Vitamin B6 Pyridoxine

New onset refractory status epilepticus is a difficult to treat neurological emergency. We report here a 39 years old male admitted to our hospital with new onset seizures presented as status epilepticus. Clinical evaluation and extensive investigations revealed an underlying autoimmune-mediated etiology with positivity for anti-NMDAR autoimmune encephalitis. His seizures could not be controlled, and he remained in a super-refractory status epilepticus, despite treatment with multiple anti-epileptic drugs in their proper doses, use of IV anesthetics in addition to a high dose corticosteroid and IVIG courses for treating his underlying disease. The patient had no previous significant past medical history, no family history of a seizure disorder and no comorbidities. Remarkably, the patient’s seizures responded successfully to treatment with vitamin B6 (Pyridoxine). He was discharged, after 117 days staying in hospital, with almost complete neurologic recovery and without recurrence of seizures after achieving control with Pyridoxine.