Spontaneous seizure remission following status epilepticus in drug-resistant epilepsy due to focal cortical dysplasia

Nadine Girard (1) , Eric Guedj (2) , Patrick Chauvel (3) , Fabrice Bartolomei (4) , Aileen Mcgonigal (5)

1 CRMBM - Centre de résonance magnétique biologique et médicale
2 Service Central de Biophysique et de Médecine Nucléaire
3 Laboratoire de Neurophysiologie et Neuropsychologie
4 INS - Institut de Neurosciences des Systèmes
5 Epilepsies, Lesions Cerebrales et Systemes Neuraux de la Cognition

We describe a patient with chronic pharmacoresistant epilepsy related to right parietal focal cortical dysplasia (FCD), who became seizure-free following an episode of convulsive status epilepticus (SE). Magnetic resonance imaging (MRI) and fludeoxyglucose positron emission tomography (FDG-PET) were performed before and after SE. Longitudinal MRI scans showed a stable appearance of the FCD with no new signal change. However, diffusion tensor imaging showed altered white matter fiber tract orientation in posterior cortices, especially in proximity to the lesion, at 3 years post-SE. FDG-PET showed more widespread hypometabolism 3 years after SE. The unusual occurrence of spontaneous seizure remission following SE in the context of FCD-related epilepsy, in association with neuroimaging evolution, suggests possible cerebral reorganization triggered by SE as a mechanism in this case.

Mots clés: Focal cortical dysplasia; status epilepticus; FDG-PET; diffusion tensor imaging

Domaines: Médecine humaine et pathologie; Neurosciences [q-bio.NC]

Nadine Girard, Eric Guedj, Patrick Chauvel, Fabrice Bartolomei, Aileen Mcgonigal. Spontaneous seizure remission following status epilepticus in drug-resistant epilepsy due to focal cortical dysplasia. Epilepsy Research, 2017, 137, pp.73-77. ⟨10.1016/j.eplepsyres.2017.09.013⟩. ⟨hal-02479808⟩