Absence status. Case reports and a review of the literature

Absence status is a form of generalized status epilepticus usually presenting as an acute confusional state. It is often initially mistaken for a psychiatric disorder, as was true in two of the six adult cases reviewed in this series. The differential diagnosis includes drug intoxication, post-ictal state, complex partial status epilepticus, transient global amnesia, organic brain syndrome, and interictal psychosis. Associated convulsive movements, such as eyelid flutter or rhythmic facial movements, if seen, should alert the clinician to consider absence status, and an electroencephalogram is needed to verify the diagnosis. Although usually occurring in known epileptics, in this small series 50% of patients did not have a history of a seizure disorder. Small fractional doses of intravenous diazepam is the treatment of choice for acute termination of the episode.