Acute prolonged ictal confusion (resembling petit mal status) presenting "de novo" in later life

Two female patients, aged respectively 52 and 70 years, with no past history of epilepsy, presented an acute prolonged confusional state. The electroencephalograms showed generalized slow spike and wave discharges with frontal emphasis. No structural neurological lesion nor progressive neurological disorder was found. Both patients responded to intravenous administration of clonazepam and were placed on regular anti-epileptic treatment. On follow-up both remained well. These cases do not fit in the classical category of petit mal status but appear to belong to a distinct entity.