"Obtundation status (Dravet)" caused by complex partial status epilepticus in a patient with severe myoclonic epilepsy in infancy.
OBJECTIVE
We report a 1-year 7-month-old boy with severe myoclonic epilepsy in infancy (SME) who exhibited complex partial status epilepticus (CPSE), which was confirmed by ictal video-EEG analysis. This boy first had a hemiconvulsion in a hot bath at age 3 months. Thereafter, he exhibited both partial and generalized seizures that were extremely intractable. At age 9 months, he had a prolonged episode of impaired consciousness that fit the "obtundation status in SME" defined by Dravet et al.


RESULTS
Ictal EEG revealed persisting irregular spike-and-wave complexes over the left hemisphere, predominantly in the occipitotemporal area, and confirmed CPSE. The EEG abnormalities with decreased level of the consciousness continued approximately 6 h after onset of the symptoms even with AED administration.


CONCLUSIONS
Because SME features both generalized and focal seizures, both types of nonconvulsive status may be seen in SME. Although Dravet et al. already reported long-lasting atypical absences in patients with SME as "obtundation status," we demonstrated CPSE in an infant with SME who exhibited a prolonged stuporous state.
Wakai
S
S
Department of Pediatrics, Sapporo Medical University School of Medicine, Japan.
Ikehata
M
M
Nihira
H
H
Ito
N
N
Sueoka
H
H
Kawamoto
Y
Y
Hayasaka
H
H
Chiba
S
S
D003128:Coma / Q000175:diagnosis / Q000209:etiology*; D004569:Electroencephalography; D004831:Epilepsies, Myoclonic / Q000175:diagnosis / Q000209:etiology*; D017029:Epilepsy, Complex Partial / Q000150:complications*; D006801:Humans; D007223:Infant; D008297:Male; D013226:Status Epilepticus / Q000150:complications*; D009626:Terminology as Topic; D014743:Videotape Recording