Refractory status epilepticus of unknown origin: think of acute porphyria

Abstract

Seizures may be the first manifestation of acute porphyria. Non-diagnosis can create a problem in that most antiepileptic drugs may worsen the porphyric state. This may lead to refractory status epilepticus, as illustrated by this case of a nine-year-old boy. Screening for acute porphyria should be a standard procedure in refractory status epilepticus of uncertain origin.