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

- Chronic pharmacoresistant epilepsy related to FCD.
- Sustained seizure freedom following status epilepticus.
- Altered white matter fiber tract orientation on longitudinal diffusion tensor imaging.
- More widespread hypometabolism on FDG-PET 3 years after SE.
- Possible cerebral reorganization triggered by SE underlying remission.

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.