Juvenile absence epilepsy relapsing as recurrent absence status, mimicking transient global amnesia, in an elderly patient

Lorenzo Muccioli, Laura Licchetta, Carlotta Stipa, Paolo Tinuper, Francesca Bisulli

Research output: Contribution to journalArticle

Abstract

We describe a 68-year-old woman who had typical absence seizures since 14 years of age. The absences were refractory to treatment and persisted into adulthood, with no seizure-free periods until seizure control at 59 years of age. After six years of being seizure-free, she presented with an episode characterized by mental confusion, abnormal behaviour, and amnesia, lasting for several hours. An EEG performed the day after, when the patient had already recovered, was unremarkable. The episode was interpreted as transient global amnesia. After two and three years, respectively, she presented with two analogous episodes lasting >24 hours. An EEG disclosed, on both occasions, subcontinuous generalized spike-and-wave discharges, consistent with absence status epilepticus (AS). The last episode occurred at 68 years of age and was successfully treated with intravenous lorazepam. After one month of follow-up, no further episodes occurred. AS is common in juvenile absence epilepsy, however, our patient showed a rather atypical course, characterized by refractory and persistent absences during adolescence and adulthood, and a tendency for AS to recur with no more absences in later life. Despite the known epilepsy history, AS episodes were initially misdiagnosed. Moreover, EEG recording and subsequent treatment were not performed until the second day of status.

Original languageEnglish
Pages (from-to)557-561
Number of pages5
JournalEpileptic Disorders
Volume20
Issue number6
DOIs
Publication statusPublished - Dec 1 2018

Fingerprint

Transient Global Amnesia
Absence Epilepsy
Status Epilepticus
Electroencephalography
Seizures
Lorazepam
Confusion
Amnesia
Diagnostic Errors
Epilepsy

Keywords

  • absence status epilepticus
  • amnesia
  • idiopathic generalized epilepsy
  • juvenile absence epilepsy
  • non-convulsive status epilepticus
  • relapse

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Juvenile absence epilepsy relapsing as recurrent absence status, mimicking transient global amnesia, in an elderly patient. / Muccioli, Lorenzo; Licchetta, Laura; Stipa, Carlotta; Tinuper, Paolo; Bisulli, Francesca.

In: Epileptic Disorders, Vol. 20, No. 6, 01.12.2018, p. 557-561.

Research output: Contribution to journalArticle

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