Absence seizures (known earlier as ‘petit mal’ seizures) are characterized by sudden ‘blank out’ or lapse of awareness of surroundings. When seizure strikes, the patient stops activities abruptly and stares into space for a short period of time. The blanking out may last only for a few seconds.
The person may not have memory of loss of consciousness that happened when he/she recovers from the seizure. These seizures may or may not be frequent. Some have absence seizure once in a while, while in others it may occur several times in an hour. If seizures are frequent, it may affect the child’s learning abilities.
These seizures are more commonly seen in children in the age group of 4-14 years. Some older teens and adults may also have it. Most of the children outgrow this condition when they get older. Some may develop another type of generalized seizure called tonic-clonic seizure.
Short-term lapse of awareness is the most common symptom of absence seizure. As the ‘blanking out’ stage occurs only for a short period of time, and also resemble day dreaming, this symptom may go unnoticed in many patients. Absence seizures are categorized into two – typical and atypical.
Typical absence seizure
It begins abruptly and last for about 20 seconds before resolving completely. Patients with this seizure may just stare at one location, unresponsive to the surroundings.
Some patients may make movements like chewing, fluttering of eyelids, or rubbing fingers. Once the seizure is through the person return back to the activity with no memory of loss of consciousness.
Atypical absence seizure
This seizure begin more slowly and last longer. Some patients may stumble and fall down during seizure. After regaining consciousness, the patient may feel confused for some time. This type of absence seizure may persist in adulthood.
Diagnosis often depends on the description of seizure. But in some cases, a description may not be enough to have a confirmatory diagnosis.
Electroencephalogram (EEG) helps to measure the electrical activity and to track abnormalities during seizures. Typical pattern of the brain activity during seizures helps in the identification of absence seizures.
Treatment includes Anti-seizure medications for stabilizing the electrical activity of brain and to prevent seizures. Low doses are given in the beginning and increased later as per need in the later stages. Some of the common anti-seizure drugs prescribed are ethosuximide, valproic acid, and lamotrigine. Prognosis is good with medication, with most of the children being able to cease anti-seizure medications by late teenage years. When seizures are controlled, learning and other aspects also get back to normal. About 70% of the children with absence seizures outgrow the condition by the time they are teenagers. This is particularly true of those children who had an early onset of seizures.
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