Everything You Need to Know About Absence Seizures In Children

Absence seizures typically affect kids aged 4 to 14 and are characterized by moments of staring into space and being unresponsive.

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Absence seizures are a type of seizure that usually affects kids. Many of the symptoms of absence seizures are subtle, such as staring off into space or being unresponsive. If your child is exhibiting symptoms like these, you might be unsure if they are experiencing a seizure or if something else is going on.

Having concerns that your child may be experiencing seizures can be extremely stressful. We've got you covered. Here, experts to help us understand what childhood absence seizures are, what they usually look like in kids, and what to do if you think your child may be having them.

What Are Childhood Absence Seizures?

Childhood absence seizures—usually referred to as childhood absence epilepsy, or CAD—are a type of petit mal seizure. These seizures are brief but can happen frequently throughout the day. They are characterized by moments of blank stares and an inability to respond to the world around you, and while these types of seizures most commonly affect kids, they (thankfully) don't cause any long-term damage, at least in most cases.

At What Age Do Most Absence Seizures Occur?

Absence seizures most commonly affect kids between the ages of 4 and 14 years old, says Shelley Varnado, MD, pediatric neurologist and epilepsy specialist at Children's Memorial Hermann and UT Health Houston. Usually, the seizures start between the ages of 5 and 7, she says. "It is rare for babies and toddlers to have these types of seizures," Dr. Varnado adds.

Childhood absence seizures are a relatively rare occurrence, affecting between less than eight in 100,000 children below the age of 15. The condition is more likely to affect girls than boys, and is usually outgrown by the time a kid hits the teen years.

What Do Absence Seizures In Children Look Like?

Some of the signs of absence seizures in kids are easy to miss and can be mistaken for other conditions or symptoms, says Dr. Varnado. For example, it's typical for parents to think their child is daydreaming or having trouble paying attention, she explains. So how can you tell the difference? During a seizure, your child will not be aware of their surroundings, says Dr. Varnado, and they will not respond if you try to interact with them.

"When I am trying to differentiate normal staring from absence seizures, I will often ask parents to try doing something mildly annoying to see if their child will respond," she describes. "Calling their name may not be effective enough, so trying to move them, putting your finger in their nose or ear, or even a light pinch (never hard enough to leave a bruise!) are the methods I usually recommend to try and get a response."

Ronald Davis, M.D., MPH, FAAP, pediatric neurologist and medical director at Pediatrix Neurology and Epilepsy of Florida, says that besides spacing out, there are a few other symptoms that might emerge. For example, absence seizures may be associated with rapid blinking and chewing movements, Dr. Davis describes. Additionally, sometimes parents confuse the symptoms of absence seizure with other common childhood disorders. "The condition frequently gets confused as ADD/ADHD, so a proper evaluation is important," Dr. Davis advises.

How Long Do Absence Seizures Last?

Absence seizures are usually quite brief, says Dr. Varnado, lasting about 10 to 30 seconds at a time. "There is no warning before the seizure happens, and the child will return to their normal level of awareness within seconds of the seizure stopping," she explains. Another feature of absence seizures is that they can happen very frequently throughout the day, as often as 20 to 50 times—or more, Dr. Varnado says.

What Causes Absence Seizures In Kids?

Experts are not entirely sure what causes these seizures. "There is no specific risk factor, though there is a genetic predisposition in some families," Dr. Davis explains. "A rare metabolic disorder called Glut-1 deficiency syndrome can cause resistant absence and should be tested for as well."

In about one in every three cases, there is a family history of absence seizures, and if a child has absence seizures, there's a one in 10 chance that their sibling will develop them too. Still, not all families discover a genetic link, and sometimes a clear cause is never determined.

How Are Childhood Absence Seizures Diagnosed?

If you suspect your child may be experiencing absence seizures, you should start by making an appointment with their pediatrician, says Juliet Knowles, MD, PhD, pediatric neurologist at Stanford Medicine Children's Health and Assistant Professor of Pediatric Neurology at Stanford University. If your pediatrician believes there is cause for concern, they will likely refer you to a pediatric neurologist.

Getting a diagnosis for absence seizures involves a detailed interview and neurological exam, says Dr. Knowles. "A non-invasive test called an electroencephalogram (EEG), which enables us to view brain activity, is often performed," she describes. "A neurologist can put these pieces of information together to determine whether seizures are occurring and, if so, what type of seizures, and an appropriate treatment strategy."

Is There Any Treatment?

Absence seizures rarely cause long-term issues, but they can have complications so they need to be treated medically. "While it may seem that these seizures are not serious when they are brief and hard to recognize, if left untreated, ongoing absence seizures can lead to learning difficulties," says Dr. Varnado.

Medication is the go-to method for treating absence seizures, says Dr. Davis. "There are many approved therapies for absence epilepsy and most respond to a single medication and are well-controlled," he says. Medications may include antiseizure medications like ethosuximide, Depakote and Lamictal. Besides medication, sometimes dietary chances (ketogenic diet or modified Atkins) can be helpful, adds Dr. Davis. That said, you should speak to your child's doctor to find the treatment that works best for your child.

Outlook For Kids With Absence Seizures

The good news is that most children diagnosed with absence seizures do well. Medications can almost always control the disorder, and either way, most kids will see their symptoms disappear in due time. "The majority of affected children will 'outgrow' their seizures and can stop taking medication without seizures returning, around the time of puberty," Dr. Knowles assures. "The overall outlook for children with childhood absence epilepsy is very positive."

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