A
fugue state is defined as an altered state of consciousness with varying degrees of motor activity and
amnesia for the event. It may last for hours to days and may be psychogenic or organic in nature. Epileptic
fugue states can be encountered in patients with absence or complex partial nonconvulsive
status epilepticus or may occur as a postictal phenomenon in patients with
generalized seizures. "
absence status epilepticus" (AS) is rare and seen in only 2.6% of the cases with "
childhood absence epilepsy" (CAE). The diagnosis of AS can be elusive, but sudden onset and termination of the
fugue state, classical electroencephalogram (EEG) features, and response to a therapeutic trial of
benzodiazepines helps in confirming the diagnosis and differentiating it from nonepileptic
fugue states. We report a childhood onset case, with
a 10 years history of recurrent episodes of prolonged
fugue state lasting for up to 24 h, as the sole manifestation of epileptic
seizures. The EEG features were suggestive of an AS, but there was no history of typical absences,
myoclonus, or
generalized tonic clonic seizures. This unusual and rare case cannot be categorized into one of the defined
epilepsy syndromes like CAE but belongs to a recently identified syndrome of
idiopathic generalized epilepsy known as "
Absence status epilepsy" in which AS is the sole or the predominant seizure type.