Objective To investigate the cerebral glucose metabolic features of patients with encephalitis and refractory status epilepticus （RSE） using 18F-fluorodeoxyglucose positron emission tomography （18F-FDG PET）.Methods A retrospective analysis was performed for the patients with encephalitis who attended West China Hospital， Sichuan University， from August 2019 to September 2024 and underwent 18F-FDG PET， and according to the condition of seizures， they were divided into RSE group， non-RSE seizure group （with seizures not meeting the diagnostic criteria for RSE）， and non-seizure group （without clinical seizures）. Cerebral metabolic features were compared aming the three groups. For the patients with seizures （the RSE group and the non-RSE group）， after adjustment for age and sex， the binary logistic regression analysis was used to investigate the association of metabolic abnormalities in different brain regions with RSE.Results A total of 51 patients were enrolled， including 16 in the RSE group， 21 in the non-RSE seizure group， and 14 in the non-seizure group. The patients with seizures had a significantly higher proportion of patients with metabolic abnormalities on PET than those without seizures （81.2% in the RSE group， 61.9% in the non-RSE seizure group， and 14.3% in non-seizure group； P=0.003）. After adjustment for age and sex， metabolic abnormalities in the occipital lobe were significantly associated with RSE （OR=10.45， 95%CI： 1.65-66.21， P=0.013）， and metabolic abnormalities in the parietal lobe showed a borderline association with RSE （OR=4.15， 95%CI： 0.92-21.52， P=0.064）， while metabolic abnormalities in the frontal or temporal lobe showed no significant association with RSE.Conclusions Patients with encephalitis tend to have extensive cerebral metabolic abnormalities at the onset of RSE， especially the involvement of posterior brain regions such as the occipital lobe and the parietal lobe.