Epileptic Disorders


Focal status epilepticus may trigger relapse of primary angiitis of the CNS Volume 24, numéro 1, February 2022


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1 Saint-Luc University Hospital, Department of Neurology, Brussels, Belgium
2 Saint-Luc University Hospital, Department of Radiology, Brussels, Belgium
3 Saint-Luc University Hospital, Department of Pathology, Brussels, Belgium
4 Antwerp University Hospital, Department of Pathology, Antwerp, Belgium
5 Saint-Luc University Hospital, Stroke/Vascular Neurology, Brussels, Belgium
6 Saint-Luc University Hospital, Centre for Refractory Epilepsy, Brussels, Belgium
* Correspondence: Susana Ferrao Santos Avenue Hippocrate 10, 1200 Brussels, Belgium

The role of neuroinflammation in epileptogenesis is extensively investigated, but short-termeffects of seizures on established CNS pathologies are less studied and less predictable. We describe the case of a woman with previous recurrent episodes of focal cerebral haemorrhage of unknown cause who developed a pseudo-tumoural oedema triggered by provoked focal status epilepticus. A brain biopsy revealed that the underlying condition was primary angiitis of the CNS. Ictal-induced blood-brain barrier dysfunction allows the entry of water and inflammatory molecules that, in the context of CNS inflammatory diseases, may trigger a self-reinforcing process. Caution should be observed when tapering antiepileptic drugs in patients with such conditions.