Idiopathic generalised epilepsy with phantom absences and absence status in a child

A syndrome of idiopathic generalised epilepsy with phantom absences of unde termined onset has been recently described. This syndrome clinically become s apparent in adulthood with generalised tonic clonic seizures and frequent ly absence status epilepticus. We report on an 11 year-old normal girl with frequent episodes of absence status and no other overt clinical manifestat ions. However, appropriate video-EEG recordings documented that she had fre quent absence seizures that were so mild as to escape recognition by her an d the parents. These consisted of mild impairment of cognition and eyelid f luttering during brief generalised discharges of spike/multiple spike and s low waves. No further seizures occurred and the EEC normalised after approp riate drug treatment. Thus, it appears that this syndrome of phantom absenc es and absence status may start much earlier, in late childhood. Appropriat e video-EEG documentation is needed for the recognition of these patients t hat may be more common than it appears from the few published cases (with V ideo).