Absence Seizures: Brief Loss of Awareness Without Convulsions

Absence seizures (formerly petit mal) are generalized non-motor seizures characterized by sudden, brief lapses of consciousness (typically 5–15 seconds) without convulsions.

Key Features

• Staring spells: Blank gaze, unresponsiveness.
• Automatisms: Lip smacking, eyelid fluttering, fumbling.
• Abrupt onset/offset: Activity stops and resumes instantly; no post-ictal confusion.
• High frequency: Dozens per day, often in clusters.
• Age of onset: Usually 4–12 years; may persist into adulthood.

Diagnosis & Treatment

• EEG: Shows classic 3 Hz spike-and-wave discharges.
• First-line meds: Ethosuximide, valproate, lamotrigine.
• Prognosis: ~70% outgrow by adolescence; others may develop other seizure types.

Differentiation

Not to be confused with focal impaired awareness seizures (longer, with post-ictal confusion) or daydreaming (interruptible).

Early recognition prevents academic/social impact. Consult a neurologist for evaluation.