SummaryFive cases of spike‐wave stupor are presented. One case occurred in association with cerebrovascular disease and another in association with the Vogt‐Koyanagi syndrome. A third case had repeated episode of spike‐wave stupor as the only sign of a seizure disorder. A fourth case was characterized by behavior quite similar to catatonic schizophrenia and was so diagnosed. These atypical cases are contrasted with a case more typical of petit mal status as reported in the literature. Thus while spike‐wave stupor is usually superimposed on a chronic centrencephalic seizure disorder, it must be recognized as a syndrome that can arise from a variety of etiological mechanisms. Detailed clinical and EEG investigation is necessary for an understanding of the mechanisms involved in any individu