ABSTRACT
A 50-year-old railwayman suffered from idiopathic absence seizures until the age of 16 years and had been seizure-free without antiepileptic treatment since then. Hypothyroidism and arterial hypertension were adequately treated. He was a heavy, habitual snorer. His wife witnessed nocturnal apnoeas and he reported excessive daytime sleepiness (e.g. falling asleep when watching television or when travelling in the train or in the car as a passenger). One day after lunch he was tired and nervous and shortly thereafter had three generalized tonic-clonic seizures in succession, corresponding to tonic-clonic status epilepticus. The patient was treated with intravenous benzodiazepines, phenytoin and muscle relaxation, followed by intubation. He was transferred to our department.
