Focal status epilepticus may trigger relapse of primary angiitis of the CNS

Abstract

The role of neuroinflammation in epileptogenesis is extensively investigated, but short‐term effects 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.