Perioral myoclonia with absence seizures: a rare epileptic syndrome

We present the clinical and video-EEG data on an epileptic boy whose absenc e seizures with marked perioral movements had started at the age of 1.5 yea rs. From age 12 years, he experienced frequent episodes of typical absence status epilepticus (ASE) lasting 1-2 hours with marked perioral myoclonia a nd moderate confusion. initial therapy with carbamazepine was substituted b y valproate because of worsening of the absence seizures. At the age of 17, the patient was admitted to our clinic with his usual, but long lasting AS E attack, accompanied by 2 generalized tonic-clonic convulsions. ASE was co nfirmed with the EEG which showed continuous 3 Hz spike and wave paroxysms with occasional normal intervals of 1-5 seconds. IV injection of clonazepam improved the clinical and EEG findings immediately. Video-EEG examination performed after a few weeks demonstrated typical absence seizures with peri oral myoclonia. Based on the characteristics of seizure semiology, other cl inical data and EEG findings, the patient was diagnosed as having the syndr ome of "perioral myoclonia with absence seizures" described by Panayiotopou los.