HIV CNS viral escape syndrome is quite uncommon. It is characterized by high HIV viral load in the CSF despite having a low serum viral load [1]. The neurological manifestations of CNS viral escape syndrome that have been reported include insidious or acute onset of headache, tremors, cognitive impairment, focal neurologic deficit, seizures, behavioral disturbance, and dysarthria [1]. We report a unique case of HIV CNS escape syndrome in a 47-year-old female with controlled HIV who presented with new-onset refractory status epilepticus (NORSE), that was seronegative for all the commercially available testing for autoimmune and paraneoplastic encephalitides.
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