Absence seizures and staring spells

Let us talk about another kind of childhood seizures called Absence seizures or at times Petit Mal seizures. Childhood absence epilepsy as the name suggests starts off in childhood. The seizures are subtle and thus may escape detection from even doting parents. Most of the time, it is the teachers in school who first report that the child at times is noted to “stare” or “daydream”. At times the school grades start falling and this brings the child to medical attention.

Absence seizures as the name suggests are short duration seizures where-in the child is “absent”. By that I mean that for the short time (few seconds to a minute)  during which the child is having a seizure, he or she is not aware of the immediate surroundings. This is because even though an Absence seizure is brief, it is a generalized seizure (meaning the whole brain has a seizure and thus malfunctions for that few seconds). It is different from a generalized convulsion in that you do not seek the violent shaking movements of the arms and legs. Thus it is subtle and may escape detection in the earlier years.

Absence seizures need to be treated. The reason for this is that the seizures are frequent, at time hundreds in a day and these frequent seizures impair the cognitive development of the child. The diagnosis is relatively straight forward and your physician might make it on the basis of a good history. An electroencephalogram (EEG) study may shown the characteristic EEG pattern of Absence epilepsy confirming the diagnosis. An imaging study is usually not needed unless there are some atypical features in the presentation.

Once the diagnosis is made, Absence seizures can be readily controlled with anti-epileptic drugs. Two drugs are commonly used for this kind of epilepsy: ethosuximide and valproate. Children usually do not need to be on anti-epileptic drugs for prolonged length of time and they usually outgrow these seizures by the time they reach the age of 17.

Dr. Sethi