LAUSR

Sir, Progressive multifocal leukoencephalopathy (PML) occurs due to the re‐activation of the polyoma John Cunningham (JC) virus in immunocompromised patients although a few reports have described its occurrence in immunocompetent patients. PML may occur in up to 5% of patients with acquired immunodeficiency syndrome (AIDS).[1] After initiation of Highly active antiretroviral therapy (HAART), patients with HIV may develop a worsening attributable to immune reconstitution, termed PML‐Immune reconstitution inflammatory syndrome (IRIS).[2] Unlike PML, patients with PML‐IRIS show contrast enhancement on MRI. The prevalence of seizures in PML is up to 18% to 44%.[3] The risk for seizures is increased if PML is located adjacent to the cortex.[4] We present the first case of refractory status epilepticus (RSE) in PML‐IRIS associated with HIV infection.