Exceptionally long absence status: multifactorial etiology, drug interactions and complications

Epileptic Disord. 1999 Dec;1(4):229-32.

Abstract

To our knowledge, petit mal status lasting longer than 2-3 days has been documented only once [1]. We report a 66 year-old man with well-documented, idiopathic generalized epilepsy who developed petit mal status lasting 6 weeks. Valproate levels remained low because of interactions with phenytoin. When phenytoin was discontinued, valproate levels increased, and he progressively improved. Chronic ischemic changes in the white matter may have been an additional factor in the causation and, most likely, in the duration of his status. Exceptionally long status and stupor increase the risk of medical complications. Valproate remains the medication of choice for the treatment of petit mal status. Despite the extraordinary course in this patient, complete recovery took place, confirming the benign nature of even such a prolonged episode.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anticonvulsants / adverse effects*
  • Anticonvulsants / therapeutic use
  • Brain Ischemia / complications*
  • Brain Ischemia / diagnosis
  • Dementia, Vascular / complications
  • Dementia, Vascular / diagnosis
  • Drug Interactions
  • Epilepsy, Generalized / drug therapy*
  • Hernia, Inguinal / surgery
  • Humans
  • Male
  • Phenytoin / adverse effects*
  • Phenytoin / therapeutic use
  • Postoperative Complications / diagnosis
  • Postoperative Complications / drug therapy
  • Postoperative Complications / etiology
  • Status Epilepticus / diagnosis
  • Status Epilepticus / drug therapy
  • Status Epilepticus / etiology*
  • Valproic Acid / adverse effects*
  • Valproic Acid / therapeutic use

Substances

  • Anticonvulsants
  • Valproic Acid
  • Phenytoin