Absence Epilepsy

What is an Absence Epilepsy

Absence epilepsy is a common type of epilepsy in childhood. Epilepsy is a disorder in which a person experiences bursts of abnormal electrical activity in the brain. It usually shows up in children between the ages of 4 and 10 years old.

As many as 1 in 5 children with absence epilepsy have had a febrile seizure earlier in life and up to 50% have a family member with a seizure disorder. There are two types of absence epilepsy:

  • Typical. In this type, your child may have staring spells. The spells come on suddenly, are usually frequent, and last approximately 10 seconds. Spells may be provoked by something that causes fast breathing, such as an emotional reaction, but not by smells or seeing certain things. They are not associated with any shaking of arms, legs, or loss of body tone causing a fall. Since staring spells are often misinterpreted as daydreaming, it may take months or even years before the epilepsy is recognized.
  • Atypical. This type involves both staring episodes and occasional convulsions in which there is rhythmic jerking of the entire body (generalized tonic-clonic seizures).

Absence epilepsy does not cause injury to the brain. Children with absence epilepsy have a normal development and intellect but have been found to score lower on tests measuring problem solving, some reading and language skills, and psychosocial function. Most people outgrow absence epilepsy by their mid-teen years.

What are the causes?

Absence epilepsy is caused by a chemical imbalance in the part of the brain called the thalamus.

What are the signs or symptoms?

An episode of absence epilepsy (absence seizure) may involve:

  • A staring spell. Your child may stop an activity or conversation when this occurs.
  • Lip smacking.
  • Fluttering eyelids.
  • The head falling forward.
  • Chewing.
  • Hand movements.
  • No response to being called or touched. Your child may continue a simple activity such as walking but will not be responsive.
  • Loss of attention and awareness.

After the seizure, your child may:

  • Have no knowledge of the seizure.
  • Be fully alert.
  • Resume his or her activity or conversation.

Children with absence epilepsy may have problems in school. They may miss information in their classes due to seizures. Because they are not aware of their seizures, from their point of view, one moment the teacher is saying one thing and then suddenly the teacher is saying something else.

Some children have a few seizures while others have hundreds per day.

How is this diagnosed?

Your child’s health care provider may order tests such as:

  • Electroencephalography. This test evaluates electrical activity in the brain.
  • A magnetic resonance imaging (MRI) of the brain. This test evaluates the structure of the brain. An MRI may not be done if your child has very clear symptoms of absence epilepsy.

How is this treated?

If seizures are infrequent, treatment may not be needed. If seizures are frequent or are interfering with school and the child’s normal daily activities, a seizure medicine (anticonvulsant) will be prescribed. The dose may need to be adjusted over time to achieve the best seizure control.

Follow these instructions at home:

  • Let those who care for your child, such as teachers and coaches, know about your child’s seizures.
  • Make sure that your child gets adequate rest. Lack of sleep can increase the chances of your child having a seizure.
  • Watch your child closely when he or she is performing activities that could be dangerous during a seizure. These including bathing, swimming, and rock climbing.
  • Make sure your child takes medicines as directed by your child’s health care provider.
  • Get approval from your child’s health care provider before:
    • Stopping your child’s prescribed medicines.
    • Giving your child new medicines.
  • Keep follow-up appointments with your child’s health care provider.
  • Monitor your child for symptoms of attention deficit hyperactivity disorder (ADHD) and anxiety. These commonly coexist with absence epilepsy, even if the epilepsy is well controlled.

Contact a health care provider if:

  • Your child’s seizures occur more often than before.
  • Your child has a new kind of seizure.
  • You suspect your child is experiencing side effects of a medicine. Side effects may include drowsiness or loss of balance.
  • Your child has problems with coordination.
  • Your child is having learning issues at school.
  • Your child is having behavior issues.
  • Your child is having problems with social interaction.

Get help right away if:

  • Your child has a seizure that lasts for more than 5 minutes.
  • Your child has prolonged confusion.
  • Your child develops a rash after starting medicines.
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