What Is Absence Seizure?

Absence seizure, formerly known as petit mal seizure, is a type of short seizure that usually causes a person to briefly lose focus, stare into space, and lose awareness of their surroundings. These seizures are often seen in children and typically last only a few seconds.

The condition is a type of epilepsy, a condition that causes seizures. Seizures are caused by abnormal brain activity, in which a burst of uncontrolled electrical activity between brain cells causes temporary abnormalities in muscle tone or movements (like stiffness, twitching, or limpness), behaviors, sensations, or states of awareness.

Absence seizures don’t cause a person to fall down or convulse. In fact, they may be hard to identify at first, because it can look like the person is just daydreaming or zoning out.

Absence seizures are generally classified into two types: typical and atypical.

Typical Absence Seizures

This is the most common form and only causes staring and lack of awareness.

Atypical Absence Seizures

People who are having an absence seizure don’t speak, listen, or seem to understand. Typically, they stare blankly and stop whatever they are doing. Just as suddenly, they “snap out of it” and continue as they were before the seizure.

Other symptoms of an absence seizure may include:

• Repetitive movements, like eye blinking or lip smacking
• Brief loss of awareness — the person doesn’t respond to others.
• No memory of having the seizure, even immediately after it happens

Absence seizures are caused by sudden bursts of electrical activity from nerve cells in the brain, called neurons, which send electrical and chemical signals across the synapses that connect them. In people who have absence seizures, the electrical signals repeat themselves over and over in a three-second pattern instead of behaving in the usual way.

Risk factors for absence seizures include:

• Genetics These seizures often run in families. Close to 1 in 4 children with absence seizures have a close relative who has seizures.
• Age Absence seizures usually start in childhood, typically between ages 4 and 14.
• Sex This type of seizure is more common in girls.

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Some people have absence seizures for years before seeking a diagnosis. Typically, a diagnosis involves a physical exam, discussion of symptoms, medical history, and tests. It helps to keep track of symptoms and know as much about what happens during the seizures as possible — which may involve what witnesses observe during the episodes.

The following tests may be used:

• Hyperventilation Test Because hyperventilating can trigger an absence seizure, the healthcare provider may try to induce one so that they can observe it. This could involve blowing on paper or a pinwheel repeatedly for two minutes.
• Electroencephalogram (EEG) This test records electrical activity in the brain. During an absence seizure, an EEG will show a characteristic pattern of brainwaves.
• Magnetic Resonance Imaging (MRI) or Computerized Tomography (CT) Scan This types of scans can reveal abnormalities in the brain that could cause seizures.
• Blood and Urine Tests These may be done to rule out other causes of seizures, such as infections or metabolic disorders.

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Usually, people (most often, children) are started on the lowest dose of antiseizure medicine possible, and then the dose may be increased (if needed) to manage the seizures.

Medication Options

• Zarontin (ethosuximide)
• Lamictal (lamotrigine)
• Topamax (topiramate)
• Depakene (valproate)
• Valproic acid

Complementary Therapies

First-line therapy for absence seizure is medication to control seizures. There is some evidence that complementary approaches may help as well, especially if the seizures aren’t improved by medication.

• Get plenty of rest
• Manage stress
• Eat a healthy diet
• Exercise regularly

While absence seizures are generally less severe than other types of seizures, there is an increased risk for certain complications or issues.

• Impaired Learning Frequent seizures can impact attention and memory, especially in children. It can also make following directions challenging.
• Injuries Though absence seizures do not typically involve falling, accidents can happen if the seizure occurs while a person is engaged in an activity that requires full attention, like walking, swimming, or driving.

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If you or someone you know experiences any of the following, seek medical help immediately:

• Seizures lasting longer than five minutes
• Multiple seizures in a row without recovery between them
• Prolonged automatic behaviors lasting minutes to hours, including eating or moving without awareness or prolonged confusion. These could be symptoms of status epilepticus, which requires immediate attention to prevent further complications or even death.

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• Childhood Absence Epilepsy The main symptom of this type of epilepsy is absence seizures without noticeable convulsions.
• Juvenile Absence Epilepsy This type of epilepsy starts in adolescence and is marked by frequent absence seizures, often occurring with other types of seizures, such as generalized tonic-clonic seizures.
• Juvenile Myoclonic Epilepsy A type of epilepsy that usually starts in the teen years, this involves quick, jerking movements, often in the arms or shoulders, which may be followed by generalized seizures, typically occurring in the morning.

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• Absence seizures are brief, sudden episodes where a person loses focus or awareness, often appearing as if they are daydreaming.
• These seizures are most common in children but can occur in adults as well.
• Treatment typically involves medications, which can help control and reduce the frequency of seizures.
• In most cases, treatment can successfully manage absence seizures.