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[Absence status epilepsy].

P Thomas1

  • 1Service de Neurologie et Consultation d'Epileptologie, Hôpital Pasteur, Nice. piertho@calva.net

Revue Neurologique
|January 19, 2000
PubMed
Summary
This summary is machine-generated.

Absence status (AS), a complex epileptic condition, presents with diverse clinical and EEG patterns. Prompt diagnosis via EEG and treatment with benzodiazepines (BZ) can lead to significant clinical improvement.

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Area of Science:

  • Neurology
  • Epileptology
  • Clinical Neurophysiology

Context:

  • Absence status (AS), also known as "Petit Mal status," is a polymorphic epileptic condition complicating various epilepsy syndromes.
  • Diagnosis is challenging based on clinical signs alone, necessitating emergency electroencephalography (EEG).
  • Typical ictal patterns involve generalized rhythmic spike-wave (SW) or polyspike-wave (PSW) complexes.

Purpose:

  • To delineate the diagnostic challenges and therapeutic approaches for absence status.
  • To describe the four recognized types of AS based on clinical presentation, EEG findings, and prognosis.
  • To highlight the utility of neuropsychological testing and benzodiazepine (BZ) response in diagnosis and management.

Summary:

  • Four types of AS are recognized: typical, atypical, "de novo" late-onset, and those with focal characteristics.

Related Experiment Videos

  • Typical AS is associated with idiopathic generalized epilepsy, presenting with isolated consciousness impairment and specific EEG patterns, generally having an excellent prognosis.
  • Atypical AS occurs in symptomatic epilepsies, characterized by fluctuating confusion and varied ictal manifestations with a guarded prognosis. "De novo" AS has variable features and prognosis, often linked to precipitating factors. Focal AS occurs in partial epilepsies with variable prognosis.

    • Impact:

    • EEG and intravenous benzodiazepine (BZ) administration are crucial for diagnosis and immediate treatment of AS.
    • Neuropsychological assessments before and after BZ injection can aid in diagnosing difficult cases.
    • Understanding the specific type of AS guides prognosis and long-term treatment strategies, potentially avoiding the need for chronic antiepileptic drugs in some cases.