Petit Mai Status with Myoclonus: Case Report

The authors describe a case of petit mal status épisodes with myoclonus in a woman of 77 years, in whom the only preceding symptom was a grand mal attack at the âge of 70. In addition to a confusional state lasting several hours, the épisodes were characterized by the presence of massive myoclonic jerks. The jerks were closely related to multiple spikes of the generalized polyspikes and polyspike‐and‐wave complexes which characterized the EEG during the status. These épisodes often ended with a grand mal attack. Between status épisodes the patient was lucid and presented a negative neurological picture, although undoubted signs of intellectual deterioration were noted. The case is notable from the polygraphic point of view for the severity of the myoclonic involvement, and from the clinical point of view for the fact that the status was the sole epileptic symptomatology which appeared in old âge. This, together with other observations in the literature, suggests the existence of primarily generalized epilepsy occurring late in life, predominant probably in females, and assuming the features of confusional states or grand mal seizures.