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July 1979

Absence Status (Petit Mal Status) With Focal Characteristics

Author Affiliations

From the Departments of Neurology (Drs Niedermeyer, Fineyre, Riley, and Uematsu) and Neurosurgery (Drs Niedermeyer and Uematsu), Johns Hopkins University School of Medicine and Hospital, Baltimore, and the National Naval Medical Center, Bethesda, Md (Dr Riley). Dr Fineyre is a Visiting Professor from the Faculté de Médecine, Paris.

Arch Neurol. 1979;36(7):417-421. doi:10.1001/archneur.1979.00500430047006

• Two patients, aged 23 and 74 years, manifested prolonged episodes of mildly impaired consciousness in conjunction with rhythmical spike waves or spikes (mostly 3/s). This paroxysmal EEG activity was consistently accentuated unilaterally over the superior frontal regions. The first patient showed ictal aphasia and occasional right hemiparesis during these episodes, and partial left frontal lobectomy resulted in temporary freedom from seizures.

The classification of these ictal episodes is difficult. They apparently fall into the category of absence status (petit mal status), but the focal neurological signs do not fit the presently valid definitions of absence status, nor does the lack of symmetrical bilateral-synchronous paroxysmal discharges. Perhaps a special category of status epilepticus should be established.

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