Late-onset epilepsy with status myoclonicus: a diagnostic and management dilemma

Status myoclonicus (myoclonic status epilepticus) has been described in generalized epilepsy syndromes, neurodegenerative disease, infectious or inflammatory neurologic disease, toxic-metabolic states, and following anoxic brain injury. It is extremely uncommon in elderly people. Hence, status myoclonicus can be a challenge to diagnose and manage especially if it is cryptogenic epilepsy (unknown cause). We describe the case of a 77-year-old female who had new-onset uncontrolled seizures despite three antiepileptic drugs. Following concern about nonepileptic events, she was eventually diagnosed by epilepsy monitoring to have status myoclonicus. Her seizures were then controlled with appropriate antiepileptic drug changes.