The authors present the case-history of a 69-year-old female patient who suffered twice from non-convulsive status epilepticus with clinical symptoms of obnubilation. As etiological causes the authors discuss hypoperfusion of the cortex associated with intracranial atherosclerotic stenosis (a. cerebri anterior, a. cerebri media both on the left side), altered excitability of the contralateral cortex by a mechanism of transcallosal diaschisis, atherosclerotic subcortical encephalopathy (M. Binswanger), SIADH syndrome and SSRI (fluoxetine) medication. Clinical characteristics of the patient resemble data in the literature on patients who suffered absence status in middle age, or in old age as the first manifestation of epilepsy.Non-convulsive status epilepticus wasin that case classified as a psychomotor state with pseudoabsence. Among others the patient was subjected to the following subsidiary examinations: ictal EEG, ictal and interictal SPECT TcHMPAO, furthermore MRI and MRA examination of the brain.

        Key words: non-convulsive status epilepticus, intracranial atherosclerotic stenosis, transcallosal diaschisis, atherosclerotic subcortical encephalopathy, SIADH syndrome, fluoxetine