Idiopathic recurring stupor (IRS) is a disease of unknown pathogenesis
presenting with recurrent stuporous states. We describe three IRS pat
ients in whom there were no metabolic, toxic, or structural brain dysf
unctions. Ictal EEGs were characterized by fast (14- to 16-Hz), unreac
tive background activity. Flumazenil, a benzodiazepine receptor antago
nist, promptly resolved the clinical and EEG picture. In all patients,
ictal plasma determination showed a marked increase in benzodiazepine
-like activity identified as endozepine-4. IRS may be due to an unexpl
ained excess of endozepine-4.