Absence Seizures in Children

Absence seizures are a universal type of seizure that usually begins during childhood. However, absence seizures can also develop in adults. These seizures are characterized by short periods of unresponsiveness that may occur several times a day. Absence seizures are categorized as typical or atypical.

When parents or teachers are aware of the symptoms, an absence seizure is easy to spot. A diagnosis is usually made after it is reported that a child often stares blankly and the child’s doctor notices a typical pattern during a seizure on an EEG. A typical absence seizure is sometimes mistaken for a complex partial seizure if the features are not typical.

What Are the Signs of Absence Seizures in Children?

Typical Absence Seizures

It will become easy to detect when a child is in the midst of a typical absence seizure because he/she will generally stop what he/she has been doing and stare blankly. In addition, his/her eyes often roll in an upwards direction and he/she will be unresponsive if spoken to or touched. These seizures usually last approximately 10-15 seconds and afterwards, the child will either be immediately alert or he/she may feel briefly confused. The child will be unaware of the seizure and, if he/she is being monitored, an EEG will show a pattern of spikes and waves during a seizure, but appear normal between them.

  • ŸFor absence seizure with mild clonic components, the child may present symptoms such as mild, subtle eyelid twitching, or twitching of the corners of the mouth and arms.
  • ŸFor absence seizure with atonic components, the child loses his/her muscle tone resulting in the body or head slumping forward or items dropping from his/her hands. Fortunately, a child doesn't usually fall during the seizure.
  • ŸFor absence seizure with tonic components, the symptoms may be symmetric or asymmetric, meaning the symptoms could be the same on both sides or stronger on one side. Tonic activity could cause the muscles to suddenly contract or stiffen. A child who is standing during a typical absence seizure could be pushed back slightly or his/her body or head may suddenly twist to the side.
  • ŸFor absence seizures with automatisms, the symptoms may resemble a complex partial seizure. A child may seem to be making movements on purpose like raising his/her eyebrows, scratching at his/her hands, licking or swallowing.
  • ŸFor absence seizures with autonomic components, the child's mouth area could be pale, the pupils could dilate, the heartrate could increase, the skin may be flushed, there may be drool or the child may wet himself/herself.

Atypical Absence Seizures

Atypical absence seizures are often more difficult to classify because it is harder to tell when their staring spells begin and end. An atypical seizure has a duration of approximately 5 to 10 seconds and children may be confused afterwards. During the seizure, their eyelids may twitch, they will have involuntarily muscle movements, their body may stiffen and they could fall.

Atypical absence seizures usually occur in children with other neurological conditions like mental retardation. They may also have other types of seizures and when their brain is monitored with an EEG, it will appear abnormal both between and during seizures.

The following video will show you clearly what happend with absence seizures in children from a boy's experience: 

When to See a Doctor

Talk to your child's pediatrician about absence seizures if you notice your child sometimes seems if as he or she is "in their own world" or stops their activity and has a blank stare. In addition, if the teacher reports that your child has been daydreaming or tuning out during class, ask the teacher to note how often it happens, how long your child seems to be tuned out and also detail any behaviors that occur during that time.

Causes of Absence Seizures in Children

Although there may be no underlying cause of a child's absence seizures, some children have a genetic predisposition to them. In addition, it may also be triggered by rapid breathing.

Absence seizures are generally the result of abnormal electrical impulses in the brain's neurons. The neurons usually send chemical and electrical signals to the synapses, but for people with a seizure disorder, the brain's activity is altered. When they have an absence seizure, the brain's signals are repeated in three-second patterns. The brain's neurotransmitters, which are the chemical messengers, may also be altered in those who have seizures.

Absence seizures are more common in children than they are in adults because many children outgrow them within a few months or years. However, some children also experience full seizures, which have tonic and/or clonic features.

Diagnosing Absence Seizures in Children

If your child's doctor suspects absence seizures, they will take a look at their complete medical history to look for any trauma during birth, any serious head injuries and possible brain infections like meningitis or encephalitis. The doctor will also examine the child's brain function by doing an electroencephalogram or EEG.

An EEG is used to detect electrochemical activity among brain cells and they usually show both characteristic and abnormal activity during a seizure. Other tests, including X-rays, MRIs or CTs are done to rule out causes of seizures.

How Is the Condition Treated?

Your child's doctor will start him/her on the lowest possible dose of an anti-seizure medication and they may increase the dosage if needed to help control the seizures. Some of the medications that are prescribed include ethosuximide, valproic acid and lamotrigine. If your child hasn't had a seizure in two years, the doctor may start tapering off the medication.

You should consider having your child wear a medical alert bracelet with his/her condition, any medications he/she takes and your contact information included on it. Also, inform the teachers, coaches and caretakers about the seizures.

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