Absence Seizure Symptoms in Kids

Absence seizures, or petit mal seizures, are often mistaken for daydreaming

Everyone loses focus sometimes — especially kids. But if your child often has trouble paying attention and remembering things, there could be another reason — an absence seizure.

“Absence seizures are subtle, brief breaks in consciousness that can look like kids are daydreaming and not paying attention,” says Akila Venkataraman, MD, a pediatric epilepsy neurologist at Geisinger. “It’s essentially a blackout that happens for a few seconds, and then they snap out of it and have no memory of the event.”

Absence seizures, formally known as petit mal seizures, are a type of epilepsy. They aren’t normally harmful, and most children outgrow them by puberty. But, you should talk to your child’s pediatrician because, untreated, they can affect your child’s life and learning.

What causes childhood absence seizures?

Absence seizures are caused by a burst of irregular electrical activity in the brain, which results in a brief loss of consciousness that can be subtle and easy to miss.

Absence seizures are most common in children ages 4 to 14. Some forms can be hereditary, but often they occur for no apparent reason in healthy children. Lack of sleep, illness, high levels of stress and hyperventilating can also contribute to absence seizures.

Absence seizure symptoms

“When people think of seizures, they generally think of what used to be called ‘grand mal’ seizures — where people fall to the ground and shake,” says Dr. Venkataraman. “But there are other types of seizures that may involve brief staring spells, and they’re harder to recognize because of their subtle nature.”

During an absence seizure, kids may suddenly stare blankly or even stop talking mid-sentence for about 10 to 20 seconds. They may flutter their eyelids, make a smacking sound with their lips or rub their fingers together. But in most cases, they won’t fall to the ground.

Usually, kids resume what they were doing as if nothing happened and they typically are not aware the seizure occurred.

“Absence seizures can happen multiple times — sometimes up to 100 per day — and are often mistaken for daydreaming or inattention because they’re so brief,” says Dr. Venkataraman. “So, a child may have them for some time before an adult notices them.”

How do absence seizures affect kids?

Absence seizures are not known to cause any damage to the brain or long-term problems. However, frequent episodes can affect learning, behavior and your child’s safety.

Absence seizures typically last no longer than 20 seconds, but that loss of consciousness can make paying attention in school and learning more difficult. Kids might miss parts of conversations or classroom instruction — multiple times a day.

And certain activities can be dangerous for children with absence seizures. For instance, episodes can occur while your child is crossing the street, riding a bike or playing sports.

“Even if your child is undergoing treatment, you should monitor them in these situations, and especially while swimming or bathing,” says Dr. Venkataraman.

Diagnosis and treatment of absence seizures

The only way to confirm a diagnosis of absence seizures is with testing for abnormal electrical activity in the brain. The electroencephalogram (EEG) is a safe and painless way of diagnosing typical absence seizures.

In many cases, absence seizures can be well controlled with standard anti-seizure medications. The goals of therapy are to control seizures on a minimum of medication to allow children to grow and learn.

Your care team also can help you implement care coordination at school and lifestyle changes, such as a regular sleep schedule and stress management, to help reduce your child’s triggers.

“Keeping a seizure diary — noting time, context and possible absence seizure triggers — is an easy way to help you and your provider spot patterns and reduce exposure to triggers,” says Dr. Venkataraman.

The good news is, most children grow out of absence seizures as they go through puberty. However, about 10% may later develop other seizure types. Thus, it’s important to establish a good relationship with your child’s neurologist to follow your child through their treatment plan.

“Early diagnosis and treatment are important to improve learning and your child’s quality of life,” says Dr. Venkataraman. “And with collaborative, ongoing care, many kids achieve strong control of absence seizure symptoms and maintain active, healthy lives.”