HP17: Electroencephalography patterns on two case studies of absence status epilepticus in adults

Abstract

Two cases of Absence Status Epilepticus (ASE), in two patients of different ages, within two different clinical contexts, and with two different Electroencephalogram (EEG) patterns. I describe here, two female patients, 30 years old (case report one) and 76 years old (case report two) that were diagnosed with ASE after prolonged EEG (260 hours and 20.5 hours, respectively) had been performed. In these cases, the clinical manifestation of ASE was different, with the cardinal symptom being memory loss in case report one and confusion in case report two. Furthermore, the EEG pattern of each patient was different as well. In case report one there were very frequent runs of high amplitude, at times sharpened, slow activity over frontal or fronto-temporal regions and bursts of 1-2Hz generalised spike/polyspike and slow wave. Conversely, in case report two there were continuous 2-3Hz generalised spike and slow wave discharges for approximately 30 hour. EEG is the gold standard technique for the diagnosis of ASE, however, it can still present variable electrographic patterns that sometimes may cast doubt on whether it constitutes a definite ASE in particular it can be difficult to ascertain whether the pattern seen is ictal or interictal, especially when clinical signs are subtle. These two cases illustrate the difficulties in diagnosis and the range of presentations of ASE.