One of my readers wrote to me today asking me a question about Absence seizures. She is a teacher and is concerned about a student in her care. I always feel teachers pick up Absence seizures far more frequently than parents. One of the reasons for this is that they spend so much time with the children (today most parents work and have limited time to spend with children). Teachers also are astute observers of children behavior and usually have a pretty good feel if something is wrong.

Here is what Ms. Lynn says, my answers to her query follow:

Ms J Lynn

Hi Dr Sethi,
I am a teacher and I have a student who is exhibiting these types of behaviors:
staring episodes, often says he can’t remember something we just talked about 30 seconds prior, he said recently that he feels like his “brain just wouldn’t work sometimes,” he has frequent meltdowns, easily agitated (but not aggressive), social (but very sensitive and easily hurt or offended), seems to have a low threshold for frustration and emotions escalate quickly, and he seems to overly react in situations when he feels physically hurt (if a ball hits him on any part of his body he is very upset, needs time to calm and he complains of feeling lots of pain).
Could all of these symptoms be related to some type of seizure activity?
Thank you for you help.

Dear Ms. Lynn,

                               thank you for writing in. Clinically seizures in children frequently look different from seizures in adults. In the case of Absence seizures, all the child may do would be to stare (hence the name staring spells), there are no gross convulsive movements seen (the child does not shake or have jerks of his arms and legs). During the time the child is having a seizure (staring), his brain is malfunctioning and hence the child is unable to recall things said or spoken to him during that time. Children may have hundreds of these small Absence seizures during the course of a day and hence you can imagine what follows. These children start slipping in their grades as compared to their peers.

I have to add here though, that not all staring spells in children turn out to be Absence seizures. As you are well aware there can be many behavioral and developmental problems in children which at times may mimic seizures (children who have Attention Deficit Disorder too do not do well in school etc).

I would advise you to report your observations to his parents. The child can be assessed by a pediatrician and further investigations if needed can then be carried out.

I sincerely appreciate your concern for your student. Teachers lay the foundation of our society. I am what I am today because of the hard work of my teachers and my parents.

Personal Regards,

Nitin Sethi, MD