Ictal generalized rhythmic alpha activity during non-convulsive status epilepticus

We investigated the repetitive manifestation of non-convulsive status epile pticus with an uncommon ictal electroencephalographic pattern observed in t wo patients suffering from epilepsy (aged 29 and 55 years). The patients ha d suffered from epilepsy since the age of 1 and 40 years, respectively Inte rictal and ictal neurological, neuropsychological and electroencephalograph ic investigations were carried out. Non-convulsive status started and ended abruptly clinically as well as electroencephalographically. The ictal elec troencephalographic pattern was a monomorphic alpha activity with a general ized bilateral distribution. Altered responsiveness, sometimes eyelid myocl onia (in one patient) and amnesia were the most characteristic clinical fin dings during non-convulsive status. Intellectual development was delayed in the patient with early onset of epilepsy. However, this was not the case i n the other patient, who developed memory impairment during the course of t he disease. In both patients, lamotrigine added to valproate reduced the fr equency of status epileptici significantly. Obviously, these patients suffe r(ed) from a type of generalized non-convulsive status epilepticus with an uncommon electroencephalographic pattern.