Epilepsy is a nervous system disorder that causes seizures, which are temporary changes in brain activity. Doctors categorize different types of epilepsy based on the kind of seizure they cause. Absence epilepsy is characterized by petit mal seizures, also known as absence seizures.
These seizures are brief, usually less than 15 seconds, and have symptoms that may be barely noticeable. However, loss of consciousness, even for such a short time, can make absence epilepsy dangerous.
Recognizing a Petit Mal Seizure
Petit mal seizures most commonly affect children ages 5 to 9, although they can occur in adults as well. Children with epilepsy may experience both petit mal and grand mal seizures, which are larger-scale seizures.
Signs a person may be experiencing a petit mal seizure include:
- staring off into space
- smacking the lips together
- fluttering eyelids
- stopping speech mid-sentence
- making sudden hand movements
- leaning forward or backward
- appearing suddenly motionless
Children with absence epilepsy are often believed to be misbehaving or inattentive.
A child’s teacher is often the first to notice absence epilepsy symptoms. The child appears temporarily “absent” from his or her body—hence the term absence epilepsy.
You can tell if a person is experiencing an absence seizure, as opposed to some other type of episode that resembles an absence seizure, because an absence seizure cannot be interrupted with touch or sound.
Large-scale seizures may begin with an aura or warning sensation. However, petit mal seizures typically occur suddenly and with no warning. This makes taking precautions to protect the patient important.
Who’s at risk for absence seizures?
Absence seizures are most common in children ages 4 to 14. It’s also possible for older teens and adults to have absence seizures, but it’s less likely.
What’s it like to have an absence seizure?
When people have absence seizures, they are unaware of what’s going on around them. For example, they won’t notice if someone tries to talk to them.
If they were saying something when the seizure started, they may stop talking in the middle of a sentence.
Some people have absence seizures for years before they know that anything’s wrong. Absence seizures are most likely to affect children, and it’s common for children not to pay attention for short periods of time — for example, at school.
In fact, the first clue a parent might have that a child is having absence seizures is that the child is having trouble in school.
What happens after an absence seizure?
When an absence seizure ends, the person usually continues doing whatever they were doing before the seizure. They are almost always wide awake and able to think clearly. No first aid is needed because of the seizure.
What Causes Absence Epilepsy?
Your brain is a complicated organ that the body relies on to maintain your heartbeat and breathing. The nerve cells in your brain communicate with each other by sending electrical and chemical signals.
A petit mal seizure interferes with this electrical activity in the brain. During a petit mal seizure, your brain’s electrical signals repeat themselves.
This pattern typically lasts about three seconds each cycle. A person who has absence seizures may also have altered levels of neurotransmitters, the chemical messengers that help cells communicate.
Researchers have not identified a specific cause for absence epilepsy. The condition may have a genetic component in some patients.
Hyperventilation or flashing lights may trigger a petit mal seizure in others. For some patients, physicians may never detect a distinct cause.
If someone has absence seizures, how often will they happen?
It depends. People who have absence seizures may have them every now and then, or they can happen very often.
Some people who have absence seizures have them more than 100 times a day.
How can I tell if someone is having an absence seizure?
A lot of the time, you can’t. That’s the tricky thing about absence seizures: Often, they come and go so quickly that no one notices anything unusual — and that includes the person who had the seizure!
It’s very common for everyone to mistake absence seizures for daydreaming or not paying attention.
During a complex absence seizure, people may:
- Blink over and over so it looks like they’re fluttering their eyelids
- Smack their lips
- Make chewing motions with their mouths
- Rub their fingers together
- Move their hands
How are absence seizures diagnosed?
Doctors will usually order a test, called an EEG (electroencephalogram), to check the brain for electrical activity that can cause seizures.
If they think someone may be having absence seizures, doctors might also ask the person to breathe very quickly.
This will often trigger (cause) seizures in people who get them.
It’s very important that people who have absence seizures get the right diagnosis from a doctor, because absences seizures are often confused with other kinds of seizures — especially complex partial seizures.
How are absence seizures treated?
There are medicines that can help prevent absence seizures. And it’s also possible that absence seizures will go away on their own.
In fact, 7 out of 10 kids with absence seizures will stop having them by age 18. Children who start having absence seizures before age 9 are much more likely to outgrow them than children whose absence seizures start after age 10.
Potential Complications from Petit Mal Seizures and Absence Epilepsy
Petit mal seizures typically last less than 15 seconds before the person returns to normal behavior. The patient does not typically have any memory of the past few moments or the seizure itself. Some petit mal seizures last longer.
These are known as atypical petit mal seizures and can last several minutes.
While petit mal seizures may have to do with the brain, they do not cause brain damage.
Most children with absence seizures will not have affected intelligence though some may have learning difficulties because of the lapses in consciousness.
As long as a person has not been injured during the seizure, a full recovery can be made almost immediately. Falls do not typically happen during the seizure.
A person can experience petit mal seizures a dozen or more times per day without any ill effects.
Because the patient is unaware the seizure is taking place, others are usually the first to notice the petit mal seizures.
Children with absence epilepsy often outgrow the condition. However, some patients may have absence epilepsy that progress to longer seizure episodes or larger seizure types.
What Is the Long-Term Outlook for Absence Epilepsy?
With regular treatment, an estimated 80 percent of absence epilepsy patients go into remission, according to New York University’s Langone Medical Center (NYU).
Many children outgrow absence epilepsy in their teens. Absence seizures can usually be controlled with anti-seizure medication, and this will help to avoid any social or academic difficulties.
What should I do if I think my child may have absence seizures?
If you think your child may be having absence seizures, talk to your child’s doctor about your concerns right away.
Kids who have absence seizures aren’t usually in danger during a seizure. However, absence seizures may cause your child to:
- Have trouble learning at school
- Have social problems
- Misbehave more often
Also, absence seizures may be confused with other types of seizures. That’s another reason why it’s so important that your child see a doctor for a correct diagnosis.
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Absence seizures or daydreaming?
If you’re wondering whether your child is daydreaming or having absence seizures, here are a few key differences to look for.
- Is likely to happen when your child is bored (like during a long class period at school)
- Usually comes on slowly, with warning (your child may go from paying attention, to a little bit “spacey,” to daydreaming)
- Can be interrupted
- Tends to continue until something stops it (like the teacher getting your child’s attention)
- Can happen anytime, including during physical activity
- Usually come on very suddenly, without warning
- Can’t be interrupted
- End on their own within 20 seconds