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When Daydreaming Isn't Daydreaming: Understanding Absence Seizures

An absence seizure is a type of epilepsy that causes brief, subtle episodes of "blanking out." Unlike the dramatic convulsions most people associate with epilepsy, an absence seizure is short and often goes unnoticed.

It is a type of generalized onset non-motor seizure and is also known as a Petit Mal Seizure. Absence seizures are more common in children and adolescents than in adults.


A child staring

Symptoms


A simple absence seizure typically causes a vacant stare lasting commonly 10–20 seconds. During this time, the person suddenly stops whatever activity they were doing. However, unlike other seizure types, there is no change in muscle tone, so falling does not occur.


After the seizure, there is usually no headache, drowsiness, confusion, or recovery period. The person has no recollection of what happened. An observer may notice unresponsiveness and a blank look on the face.


The less common symptoms include -

  • Lip smacking

  • Eyelid flutters

  • Chewing motions

  • Finger rubbing

  • Small movements of both hands


Absence seizures can happen hundreds of times per day, which can interfere with daily life and school performance. As a result, a decline in a child's learning ability may be the first sign of the seizure disorder.


Often misdiagnosed or undiagnosed


Some people have absence seizures for many months or even years before the problem is recognized. It is very common for these seizures to be mistaken for daydreaming or inattention. Additionally, children with absence seizures are often misdiagnosed with ADHD (Attention Deficit Hyperactivity Disorder).


Treatment


Absence seizures are highly treatable. Not treating them is risky because a child can be injured during a seizure (e.g., while crossing a street, riding a bike, or swimming) and the seizures disrupt learning in school.


Certain anti-seizure medicines can help prevent absence seizures. Usually these are recommended for most children.


Outlook and Long Term Management


The long-term outlook varies from child to child. For approximately 7 out of 10 children, absence seizures resolve on their own by age 18. In these cases, medication may no longer be needed once the child reaches adulthood. A key factor is the age at which seizures begin: children who start having absence seizures before age 9 are far more likely to outgrow them than those whose seizures begin after age 10.


For other children, ongoing medication may be necessary. In some instances, different types of seizures can develop over time, such as generalized tonic-clonic seizures or myoclonic seizures. These additional seizure types tend to occur more often when absence seizures started after the age of 10.


A neurologist can help you learn about the risks, treatments, and outlook for the future.


References






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