Absence seizures are the second most common type of seizure, affecting 10 percent of children with epilepsy. Absence seizures are seen in childhood absence epilepsy, although they are not exclusively limited to this syndrome.

What Are Absence Seizures?

Absence seizures involve short, sudden lapses of consciousness. Seizures are unregulated electrical discharges in the brain that lead to abnormal brain activity. There are different types of seizures, and absence seizures fall under the group of generalized seizures, meaning seizure activity affects both sides of the brain.

There are two subtypes of absence seizures: typical and atypical. Typical absence seizures are more common and last between 10 to 20 seconds. Atypical absence seizures are less common and last 20 seconds or more.

Staring spells are a hallmark of absence seizures. When the seizure occurs, a person will be unresponsive, spaced out, or have a blank stare for a few seconds. Afterward, the person continues their normal activity, not knowing they had a seizure. Absence seizures are often mistaken as daydreaming.

Absence seizures are rare in adults but more common in children between the ages of 4 and 14. These seizures typically do not cause long-term health problems or physical injuries, and about 60 percent of children with this type of epilepsy will be seizure-free by adolescence.

Symptoms of Absence Seizures

Symptoms vary from person to person depending on their age and the severity of the seizure. However, the majority of people who have absence seizures will experience staring spells for up to 15 seconds, without a headache, drowsiness, or confusion. The seizure can occur without warning and may go unnoticed.

Some children may have between 10 and 100 absence seizures in a day, making daily activities such as concentrating at school difficult. Often, the first sign of absence seizures is when a child is having difficulty learning or concentrating. The child’s teacher may express concerns about daydreaming or an inability to focus on tasks. Other symptoms include:

• Pausing in the middle of a sentence
• Going suddenly still or motionless
• Eyelid fluttering
• Lip smacking
• Facial muscle twitching
• Sudden hand movements

What Causes Absence Seizures?

Experts do not fully understand what causes the abnormal brain activity that leads to absence seizures. Absence seizures are believed to have a genetic component, and certain factors may increase the risk of seizures. Common factors that increase a person’s risk of developing or triggering absence seizures include:

• Being 4 to 14 years old
• Being female
• Having a family history of seizures
• Hyperventilating
• Taking anticonvulsants, such as phenytoin, carbamazepine, or vigabatrin
• Experiencing stress
• Not getting enough Lack of sleep

How Are Absence Seizures Diagnosed?

Speak with your doctor if your child experiences any symptoms of absence seizures. During the medical visit, you will be asked about your child’s overall health, medications, symptoms, pre-existing medical conditions, and family health history. The doctor may also ask about any social isolation, learning difficulties, or behavioral problems. If your doctor suspects seizures, they will likely refer you to a neurologist who can conduct further testing, including electroencephalogram (EEG) and other types of exams.

Electroencephalogram

An EEG is a test used to diagnose seizures. Electrodes are placed onto your child’s scalp, and their brain activity is recorded in spikes and waves. A neurologist can distinguish normal versus abnormal brain activity and diagnose an absence seizure. An EEG is typically the first tool used to confirm an absence seizure diagnosis.

Other Tests

Further testing may sometimes be needed to rule out other medical conditions. These tests include:

• CT or MRI scans
• Blood tests
• Kidney and liver function tests
• Cerebrospinal fluid test (spinal tap)

Treatments for Absence Seizures

Many treatment options are available today. Treatment plans are typically based on a child’s age, seizure type, and severity of symptoms.

Antiepileptic Drugs

Antiepileptic drugs (AEDs) are effective in treating a variety of seizures. Examples of AEDs to treat absence seizures include:

• Valproic acid (Depakene)
• Levetiracetam (Keppra)
• Lamotrigine (Lamictal)
• Topiramate (Topamax)
• Ethosuximide (Zarontin)
• Zonisamide (Zonegran)
• Clobazam (Onfi)

Lifestyle Changes

Along with medication, absence seizures can sometimes be controlled by adopting certain lifestyle habits. People living with absence seizures are advised to maintain a healthy diet, exercise regularly, get plenty of sleep every night, and manage stress.

Ketogenic Diet

A high-fat and low-carbohydrate diet such as a ketogenic diet has been found to improve absence seizure symptoms. However, this diet is not easy to sustain, and constipation is a common side effect. Work together with a dietitian and your neurologist if you plan to start a ketogenic diet.

Talk With Others Who Understand

MyEpilepsyTeam is the social network for people with epilepsy. On MyEpilepsyTeam, more than 109,000 members come together to ask questions, give advice, and share their stories with others who understand life with epilepsy.

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