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Absence Seizures

Absence Seizures

What are absence seizures?

Absence seizures generally last just a few seconds, and are characterized by a blank or "absent" stare. They're also called petit mal seizures. Absence seizures are most common in children and typically don't cause any long-term problems.

Absence seizures usually occur in children between 4 to 12 years old. A child may have 10, 50, or even 100 absence seizures in a given day and they may go unnoticed. Although most children who have typical absence seizures are otherwise normal, absence seizures can hinder learning and affect concentration at school, so treatment must be prompt.

Absence seizures are a type of epilepsy, a condition that causes seizures. Epilepsy is also referred to as a “seizure disorder.” Seizures happen when the brain sends abnormal, erratic electrical impulses. These mixed messages confuse your brain and cause a seizure. 

Not everyone who has a seizure has epilepsy. Health experts say a diagnosis of epilepsy can be made after two or more seizures.

Absence seizures often occur along with other types of seizures that cause muscle jerking, twitching, and shaking. But, sometimes absence seizures may cause twitching of the eyelid and facial muscles. If this occurs, another type of seizure called complex partial seizures may be mistakenly diagnosed. However, complex partial seizures begin with an aura or premonition that a seizure is coming whereas absence seizures do not begin with aura. Absence seizures also do not last as long as complex partial seizures, tend to end suddenly, and don’t cause a period of confusion after the seizure. Doctors pay close attention to these details because getting the right diagnosis is essential for effective and safe treatment of seizures.

It's uncommon for absence seizures to continue into adulthood, but it's possible to have an absence seizure at any age.

What causes absence seizures?

An irregularity in the brain's normal electrical activity causes absence seizures. But, doctors often don’t know why this happens. Most absence seizures are less than 15 seconds long. It's rare for an absence seizure to last longer than 15 minutes. Absence seizures strike suddenly without any warning signs.

What are the symptoms of absence seizures?

The easiest way to identify an absence seizure is to look for a vacant stare that lasts for a few seconds. People in the midst of having an absence seizure don't speak, listen, or appear to understand. An absence seizure doesn't typically cause you to fall down. You could be in the middle of making dinner, walking across the room, or typing an e-mail when you freeze, then suddenly snap out of it, and continue as you were before the seizure.

These are other possible symptoms of an absence seizure:

  • Being very still
  • Smacking the lips or making a chewing motion with the mouth
  • Fluttering the eyelids
  • Stopping activity (suddenly not talking or moving)
  • Suddenly returning to activity when the seizure ends

If you or your child experiences jerking motions, it may be a sign of another type of seizure taking place along with the absence seizure.

How are absence seizures diagnosed?

You may have absence seizures repeatedly for years before heading to the doctor for a diagnosis. You may think of or call these symptoms your "staring spells," without thinking of them as a medical problem or a seizure.

An electroencephalogram (EEG) is a test most often used to diagnose absence seizures. This test records the brain's electrical activity and spots any abnormalities that could indicate an absence seizure.

These tests also can help to diagnose absence seizures or rule out other conditions:

  • Blood tests
  • Tests of the kidneys and liver
  • CT or MRI scans
  • Spinal tap to test the cerebrospinal fluid 

How are absence seizures treated?

Absence seizures can affect your ability to perform at work or school, so it's a good idea to see your doctor about treatment.

Absence seizures can be treated with a number of different antiseizure medications.

  • Valproic acid
  • Acetazolamide
  • Lamotrigine
  • Clonazepam
  • Ethosuximide

Only ethosuximide and valproic acid are FDA approved to treat absence seizures. The drug selected will also depend on what other seizure disorder may be present. Many people who suffer from absence seizures also have generalized seizures and so would need to take one or more of the medications listed above.

Can absence seizures be prevented?

Taking your medications exactly as your doctor prescribed is one of the best ways to manage absence seizures. But you can also make some changes in your life to help prevent absence seizures from happening:

  • Get plenty of sleep each night.
  • Find ways to manage your stress.
  • Eat a healthy diet.
  • Exercise regularly.

Living with absence seizures

Most people with epilepsy live full and active lives with medicine and other lifestyle changes. But, it can be challenging, at times, to manage large and small life events when you have epilepsy. Depending on your age and the severity and type of epilepsy, you may need support with the following:

  • Behavioral and emotional issues. It is important to get enough sleep and manage stress when you have epilepsy. Stress and lack of sleep can trigger seizures. If you have trouble sleeping, talk to your doctor about how to make sure you get enough sleep. Learn coping techniques that help you manage stress and anxiety.
  • Employment. With proper treatment, people with epilepsy can do just about any job safely and effectively. But, certain jobs in which there is a high risk to public safety may not be an option. Epilepsy is covered under the Americans with Disabilities Act. This law prohibits discrimination against people with epilepsy and other disabilities.
  • Coping with discrimination and stigma. Children and adults with epilepsy may face discrimination and struggle to overcome the stigma associated with this neurological condition. Help educate family, friends, co-workers, and classmates on your condition. Let them know what to expect and how to help during a seizure.
  • Education. Children with epilepsy may be entitled to special services under the Individuals with Disabilities Education Act (IDEA). Working closely with the child’s teacher and school nurse will help improve management of epilepsy at school. It’s important for parents of children with epilepsy to balance safety and fun. Allow your child to have some age-appropriate independence and participate in sports and other activities at school, when possible.
  • Driving. Each state has different driving laws for people with epilepsy. Licensing may depend on how severe seizures are and how well they are controlled. Consider public transportation where it is available. If you continue to have absence seizures, it may not be safe for you to drive.
  • Support and online resources. You may feel alone in dealing with day-to-day life with epilepsy, but be assured that many others (1 in 26 people) have epilepsy. You can find local support groups through your doctor or local hospital. Many online resources provide tools and tips for managing this condition. Online, social media support groups bring together people from all over the world who are managing their epilepsy to provide support and encouragement.

If you have trouble managing your absence seizures, you may want to work more closely with your doctor to find a better way to treat them.

Key points about absence seizures

  • Absence seizures are seizures that generally last just a few seconds, and are characterized by a blank or "absent" stare.
  • Absence seizures usually occur in children between 4 to 12 years old, but it's possible to have an absence seizure at any age.
  • Absence seizures are easy to miss, but tests and an evaluation of symptoms can diagnose them.
  • Doctors can usually help find the right mix of medications and lifestyle changes to manage absence seizures.
  • Without treatment,school performance, work, and relationships can suffer.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.
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