A seizure can be alarming, especially in children, who are often unable to describe it or call for help. Seizures are sudden bursts of electrical activity in the brain that cause changes in behaviour, movement, and levels of consciousness.
When you think of seizures, you often describe it interchangeably with convulsions, or uncontrollable shaking. However, some seizures can be absent. Absence seizures, previously known as petit mal seizures, are a type of seizure characterised by brief lapses in consciousness, often with little to no movement. Then how do we recognise 'absence seizures'? An expert shares insights.
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What Are Absence Seizures?
Absence seizure is a type of seizure that has its own distinct characteristics. These include:
No convulsions or dramatic physical changes; they generally involve staring without shaking or falls.
Very brief episodes, lasting only seconds with no postictal state, meaning very short or absent symptoms like confusion or drowsiness after a seizure.
Generalised seizure, involving abnormal electrical activity across the entire brain, often with classic 3 Hz spike-and-wave EEG patterns.
According to StatPearls Publishing, absence seizures affect approximately 6.3-8 children per one lakh individuals per year. It is a common paediatric epilepsy syndrome that affects 10-17% of all cases of epilepsy in school-aged children.
How To Spot Absence Seizures
Dr Suhail Ambi, Consultant Paediatrician, HCG-Suchirayu Hospital, Hubli, recommends parents watch out for certain signs that can signal absence seizures. These include:
- Sudden blank staring, abruptly interrupting activity or speech
- Inability to respond when spoken to, lasting around 10–20 seconds
- Subtle movements, such as eyelid fluttering, lip-smacking, or minor hand motions
- Frequent, repetitive episodes, sometimes dozens per day, especially if the child resumes without awareness or memory of them.
According to Dr Ambi, parents might sometimes mistake absence seizures for behavioural problems like inattention and daydreaming. This happens because of overlapping symptoms:
- They resemble daydreaming or momentary distraction, especially in a classroom setting.
- Children don’t react to attempts to interrupt these episodes, while normal daydreaming can be broken by calling their name.
- Episodes occur suddenly and end on their own in seconds, whereas daydreaming arises gradually and persists until attention is redirected.
Understanding The Triggers Of Absence Seizures
According to the Mayo Clinic, absence seizures usually have a genetic cause. Dr Ambi supports the claim, as inherited variations in genes control brain cell activity, particularly those related to calcium and GABA channels. However, other triggers include:
- Hyperventilation
- Stress
- Lack of sleep
- Flashing lights
- Some medications
Can Absence Seizures Be Cured?
Before looking for a cure or a treatment, it is crucial to first identify and diagnose absence seizures.
Dr Ambi shares that a doctor may check for a detailed history describing the episodes and frequency of the seizures. They may use an Electroencephalogram (EEG) showing characteristic 3 Hz spike-and-wave discharges, often triggered by hyperventilation. Or some patients may have to undergo an MRI or CT imaging, if needed, to exclude structural causes – though typically not required in classic cases.
The good news is that absence seizures can be managed in most patients. “With appropriate anti-seizure medication, most respond very well to the treatments and can control the episodes.
“Ethosuximide is considered the first-line drug for typical absence seizures; valproate is used especially if other seizure types are also present,” shares Dr Ambi, adding that studies show 57–74% of children become seizure-free by adolescence, often allowing medication to be gradually withdrawn after 2–3 seizure‑free years under medical supervision.
Conclusion
Absence seizures can be different to spot or recognise, as they may occur for a very brief period and/or have overlapping symptoms – those that are mistaken for inattention or daydreaming. Therefore, if you find your child staring blankly at nothing, or showing no response at all, or doing repetitive actions like lip smacking and eye fluttering, consulting a doctor may be the right way to move forward.