• Yongning Jiang and Xiangqin Zhou.
• Department of Neurology, Dandong Central Hospital, Liaoning, China.
• Medicine (Baltimore). 2023 Nov 10; 102 (45): e35601e35601.

RationalePhantom absences refer to mild and short-lasting absence seizures, which are usually accompanied by infrequent generalized tonic-clonic seizures and absence status. Generally, phantom absences do not impair the individual neurological functions. Herein, we report the case of a young woman with idiopathic generalized epilepsy, phantom absences, absence status, and generalized tonic-clonic seizures.Patient ConcernsA 31-year-old woman presented with a 16-year history of paroxysmal convulsions.DiagnosesElectroencephalogram (EEG) showed recurrent universal and synchronized 3~4 Hz spike waves and spike-slow waves in the interictal phase with normal background activity. During the ictal phases, EEG revealed bursts of 3~4 Hz spike waves and spike-slow waves that were universal, synchronized, and symmetrical. Additionally, there was 1 seizure episode induced by a 3-Hz flash in the current case. Based on these findings, a diagnosis of idiopathic generalized epilepsy was made.InterventionsThe patient was treated with oral sodium valproate, and the epileptic seizures were controlled.OutcomesThe frequency of absence seizures was significantly reduced and there were no generalized tonic-clonic seizures.LessonsIdiopathic generalized epilepsy with phantom absences, absence status, and generalized tonic-clonic seizures is an extremely rare condition. EEG is the exclusive method for diagnosis. Antiepileptic drugs are effective for controlling epileptic seizures in this disease.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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