Absence seizures are a common type of generalized seizure in children. About 10 percent of seizures in children with epilepsy are absence seizures. They’re often linked to childhood absence epilepsy but can also occur with other epilepsy syndromes.

Unlike some severe childhood seizures that involve prolonged convulsions or falls, absence seizures are usually brief and subtle. However, frequent episodes can still affect learning, attention, safety, and daily life.

Here, you can learn how to recognize absence seizures, how long they last, what may trigger them, and how they’re treated.

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 other symptoms such as headache, drowsiness, or confusion. The seizure can occur without warning and may go unnoticed.

Episodes are typically frequent. Many children experience 10 to 30 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 possible symptoms include:

• Pauses in the middle of a sentence
• Sudden stillness or cessation of movement
• Eyelid fluttering
• Lip smacking
• Chewing movements
• Small hand movements

What Causes Absence Seizures?

Health experts don’t 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.

According to Cleveland Clinic, common risk factors for developing absence seizures include:

• Being 4 to 14 years old
• Being female
• Having a family history of seizures

Triggers can include:

• Hyperventilating
• Not getting enough sleep

Taking anti-seizure drugs, such as phenytoin, carbamazepine, or vigabatrin, doesn’t increase the risk of developing absence seizures. However, these drugs may worsen or trigger absence seizures in people who already have absence epilepsy.

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, preexisting 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 electroencephalograms (EEGs) and other types of exams.

Electroencephalogram

An EEG records the brain’s electrical activity using electrodes placed on your child’s scalp. In children with absence seizures, the test may show a characteristic spike-and-wave pattern.

A neurologist uses the description of the episodes together with the EEG findings to diagnose absence seizures. An EEG is often the first test used to help confirm the 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.

Anti-Seizure Drugs

Anti-seizure drugs are effective in treating a variety of seizures. Ethosuximide (Zarontin) and valproic acid are generally the most effective treatments for most people with absence seizures, while lamotrigine (Lamictal) is often used as an alternative.

Ethosuximide is considered first-line treatment for absence seizures when they occur without other seizure types. Valproic acid is often preferred when absence seizures occur together with generalized tonic-clonic seizures because it provides broad coverage for both seizure types.

Other anti-seizure drugs that may be used to treat absence seizures in certain circumstances include:

• Levetiracetam (Keppra)
• Topiramate (Topamax)
• Zonisamide (Zonegran)

Lifestyle Changes

Along with anti-seizure medication, absence seizures can sometimes be better managed 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
• Manage stress

Ketogenic Diet

Doctors may recommend following a ketogenic diet, a restrictive high-fat, low-carbohydrate dietary regimen, if seizures are not well controlled with medication.

Ketogenic diet therapy has been found to improve absence seizure symptoms. However, it’s 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 Your Child’s Doctor

Absence seizures can be easy to miss, especially when they look like daydreaming. Talk with your child’s doctor if you notice frequent staring spells, pauses in activity, or trouble concentrating. The right diagnosis and treatment can help control seizures and support your child’s daily life.

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