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Absence Seizure in Children: The Signs to Look for - GoodRx
Absence Seizure in Children: Signs, Symptoms, and Treatment
Written by Alicia Stevens, MD | Reviewed by Karla Robinson, MD
Published on December 1, 2022
Key takeaways:
Absence seizures are a common form of epilepsy in children. They generally begin between the ages of 4 and 12 years old.
Absence seizures can occur frequently and subtly. This may result in a delayed diagnosis.
Absence seizures can be managed with medications as needed. Many children outgrow them in adolescence without any long-term complications.
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Absence seizures can be tough to identify. That’s because they don’t look like what most people think of as seizures. They don’t involve convulsions or shaking and can be subtle. But they are very common — especially in childhood. Up to 17% of seizure disorders in children are absence seizures.
What are absence seizures?
Absence seizures are brief interruptions in normal brain activity. These seizures are most common in children 4 to 14 years old. They often fall into two categories: classic absence seizures and atypical absence seizures.
Classic absence seizures
Classic absence seizures are characterized as brief staring spells that last fewer than 10 seconds. During these episodes, almost all activity stops. But there’s no loss of consciousness.
For example, when children have an absence seizure while speaking, they will stop in the middle of a sentence. And then they’ll resume activity without knowing what happened.
People often mistake these events as daydreaming or a child that’s not paying attention. To someone watching, it can look like a simple pause. In some cases, there may be notable changes in eye or eyelid movements.
Atypical absence seizures
Atypical absence seizures typically last a little longer. They involve other types of muscle movement, such as smacking the lips or rubbing the fingers together.
They typically last about 20 seconds or more. These can often begin slowly — making it hard to tell when they start. But it can appear that the child’s movements have slowed down during the episodes.
These absence seizures can occur multiple times per day. Because these are subtle and brief, absence seizures can get missed. So it can take months to years to get a diagnosis.
What causes absence seizures?
Absence seizures result from an abnormal electrical discharge affecting both sides of the brain. Researchers don’t understand exactly why this happens. It may be due to an increase in activity of certain neurotransmitters (special chemicals that send messages in the brain).
Children with a family history of absence seizures are more likely to have them. But researchers have not identified a specific gene linked to absence seizures.
What can trigger an absence seizure?
Hyperventilation (rapid breathing) can easily trigger absence seizures. The reason for this is unclear. Absence seizures share triggers with other forms of epilepsy. These common triggers include:
Poor diet
Dehydration
Flashing lights or patterns
Menstrual cycles or other hormonal shifts
Over-the-counter medications (like diphenhydramine and aspirin)
Certain prescription medications (like bupropion and cyclobenzaprine)
For people with a diagnosed seizure disorder, another common trigger is missing a dose of a seizure-control medication.
What are the earliest warning signs of absence seizure in children?
Absence seizures can be very brief, making them difficult to spot. But repeated staring spells can be a sign of absence seizures.
Some children are labeled as “inattentive” or “daydreamers.” But daydreaming can be interrupted by getting the child’s attention. This isn’t the case for an absence seizure.
Poor school performance can sometimes be the first sign of absence seizures. This should always prompt a full evaluation of potential causes.
How do you diagnose absence seizures?
A history of witnessed seizures along with the results of an electroencephalogram (EEG) leads to the diagnosis.
History of symptoms
A detailed history of symptoms can help differentiate absence seizures from other types of seizures. Several key features of absence seizures are:
No warning signs before the seizure (aura)
No confusion after the seizure
No sleepiness or extreme fatigue after the seizure
These features help to set absence seizures apart from focal impaired awareness seizures, which can look the same.
EEG
During an EEG, a healthcare provider places pads on the scalp to measure the electrical pattern in the brain. This appointment generally lasts about 1 hour.
For absence seizures, the provider may want the person to be sleep deprived during the EEG. A sleep-deprived EEG is done the day after someone has slept at least 4 hours less than usual.
How do you treat absence seizures in children?
Medications are a common part of treatment for absence seizures. The most commonly used medications to control absence seizures include:
Identifying and avoiding triggers are important parts of treatment. Proper nutrition, sleep, and hydration also help manage and prevent seizures.
Finding out that your child experiences seizures can be a scary experience. The good news is that 70% of children with absence seizures will outgrow them to be seizure free by the age of 18. This is particularly true if the seizures started before the age of 9 years old. And you won’t have to go at it alone — a neurologist will work with you and your child to figure out the best treatment plan.
Are absence seizures dangerous?
Absence seizures can be dangerous if they occur during potentially hazardous situations. This typically includes activities that can result in harm if someone loses focus, like:
Driving
Swimming
Fast-pitch baseball
Bike riding
But most sports are safe even if absence seizures aren’t fully controlled. There are safety measures you can take to reduce the risk of harm, so your child can safely participate. These include:
Having a buddy present who knows basic life support
Wearing a high-quality life vest that fits well (for water sports)
Wearing appropriate safety gear or helmets
Participating in designated areas for the sport, away from traffic
Children can play contact sports on a case-by-case basis. It’s best to discuss this with your healthcare provider.
When is an absence seizure an emergency?
If absence seizures change from their typical pattern, you should seek medical attention right away. This includes any signs, like:
Loss of consciousness
Sleepiness
Jerking or stiffening movements
The bottom line
Absence seizures are a common form of childhood epilepsy. They are subtle and sometimes hard to spot. This can lead to a delay in a diagnosis. But the good news is that most children outgrow them by the age of 18. Until then, a neurologist can manage absence seizures with medications and safety precautions.
References
Albuja, A. C., et al. (2022). Absence seizure. StatPearls.
Epilepsy Foundation. (n.d.). Absence seizure.
Epilepsy Foundation. (n.d.). Seizure triggers.
LGS Foundation. (2022). Absence and atypical absence seizures.
Panayiotopoulos, C. P. (1999). Typical absence seizures and their treatment. Archives of Disease in Childhood.
Posner, E. (2015). Absence seizures in children. Clinical Evidence Handbook.