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Childhood Absence Epilepsy

What is childhood absence epilepsy?

Childhood absence epilepsy is characterised by brief episodes of staring with impairment of awareness and responsiveness. The episode usually lasts about ten seconds but may last as long as 20 seconds. The seizures usually start and end abruptly. Sometimes the eyes may blink rapidly or roll upwards, or there may be minor twitching of the face. They can be mistaken for daydreaming, or lack of concentration. The main problem is that they may happen many times a day, leading to learning problems and a lack of awareness of what is going on around them.

How common is it?

Childhood absence epilepsy is relatively common. Approximately 8% of school age children with epilepsy have this syndrome. In the majority of cases, childhood absence epilepsy begins in children between the ages of 3-12, with peaks around 6-7 years. It is more common in girls than boys.

Epilepsy and childhood absence seizures

  • There is a genetic predisposition to childhood absence epilepsy.
  • The seizures are short in duration, typically lasting 5-15 seconds. 
  • The seizures start and end suddenly.
  • After the seizure, the child usually carries on as if nothing has happened.
  • During the seizure, the child experiences a loss of awareness and responsiveness. They stop talking, eating, walking and remain motionless, with vacant eyes, staring ahead or drifting upwards.
  • Multiple seizures occur during the day. A child can have up to 200 seizures a day.
  • Absence seizures occur spontaneously, but are influenced by environmental factors. They are often photo and hyperventilation sensitive. Other triggers are emotional-anger, fear, embarrassment, boredom and metabolic disturbances.
  • Eyelid myoclonus is common.
  • In approximately 75% of children, absence seizures remit by age 18.
  • About 40% of children with absence seizures will develop tonic-clonic seizures during adolescence.
  • Up to 30% of children may show subtle cognitive impairment.
  • Seizures respond well to medication.

Interventions

The majority of children with childhood absence epilepsy will need no interventions. The key factor in helping a child with childhood absence epilepsy is to recognise the seizures.

  • Identify any trigger factors and plan to avoid these. (See EQIs ‘Seizure Triggers fact sheet’)
  • Frequent seizures can lead to children misunderstanding instructions resulting in inconsistent or deteriorating academic performance. Repeat any information that child has missed, as soon as their seizure is finished.

Please CLICK HERE to download this fact sheet.

References:

Appleton, R., Gibbs, J. (1995). Epilepsy in Childhood and Adolescence. London: Martin Dunitz Ltd. Devinski, O. (1994). A Guide to Understanding and Living with Epilepsy. Phildelphia: F. A. Davis Company. Roger, J., Bureau, M., Dravet, C., Dreifuss, F., Perret, A., & Wolf, P. (1992). Epileptic Syndromes in Infancy, Childhood and Adolescence. London: John Libbey. Santilli, N., Dodson, W., Walton. A (1991). Students with Epilepsy. New Jersey: HealthScan Inc.