Absence crisis: causes, symptoms and treatment

Epilepsy is a neurological disease characterized by the presence of crisis. The crises that are most present in our minds when we speak of epilepsy are those with violent contractions of the muscles and loss of consciousness.

But they are not the only type of crisis that someone can suffer. Absence crises, or petit mal, they are much more discreet and physically innocuous, but they must also be treated.

What is an absence crisis?

Nor are all absence crises the same. Due to how fleeting they are, they are often not identified and parents of children who suffer from them take time to realize that their child has epilepsy.

Let's see in what ways absence crises manifest and what can be done with the people who suffer them.

Symptoms

Absence seizures are present almost exclusively in children. They are characterized by a short period, usually about 15 seconds, where the individual who suffers them seems completely distracted and with a blank look. As if he was absorbed in his world. Typical signs and symptoms are:

• Lip smacking
• Fast blinking
• Motor activity stops suddenly
• Chewing movements
• Small movements in both hands

These crises begin abruptly, in which the patient stops what he was doing or saying, he suffers the crisis maintaining the same position, and when the crisis is resolved he continues with the activity that he was doing. There is no memory of the episode of any kind, and you will often be surprised if someone else tells you that you just went blank for a few seconds.

Because children with absence seizures can appear to be simply distracted, many parents become confused and believe that all that is happening is that they were mentally absorbed in something. Teachers are usually the first to notice, although teachers can also get confused and talk to parents about how the child seems to disconnect from class from time to time. If these phenomena occur frequently, it is likely that it is an absence crisis and not a distraction crisis.

Not all absence seizures are the same. Although most begin and end abruptly and quickly, there is an atypical form of seizure where the symptoms are identical, but start more slowly and last longer. In addition, during the crisis the person may lose muscle tone or fall, and after the crisis they will feel very confused.

Causes

In most cases, absence seizures are not manifestations of any underlying disease. Seizures simply occur because the child is predisposed to electrical disturbances in the brain that cause the episodes. The electrical impulses that neurons use to communicate with each other become abnormal. In absence seizures, these electrical signals from the brain repeat in a repeating pattern lasting three seconds.

This predisposition to suffer absence seizures is probably genetic and is transmitted from generation to generation. Some children have seizures when they hyperventilate, while others have seizures under strobes. The exact cause that triggers attacks is often unknown, but that does not prevent attacks from being treatable.

Treatment

Once the child goes to the neurologist, it is likely that he will confirm the diagnosis by provoking a seizure and measuring it through an electroencephalogram. What's more, Imaging tests such as an MRI will be necessary to rule out other diagnoses that can cause similar symptoms and ensure that it is pure absence seizures.

Once the diagnosis is made, children with absence seizures receive drug treatment. Antiepileptic medication is typically used, starting with low doses until the dose necessary to prevent further seizures is reached. Some common antiepileptic drugs are ethosuximide, valproic acid, and lamotrigine. Any of the three active principles will be effective and safe, although the preference for one or the other will depend on the characteristics of the specific case.

There are some activities that should be avoided in people with absence seizures, as they cause a temporary loss of consciousness. For example, riding a bicycle or swimming could end in an accident or drowning. Until the seizures are under control, these children (and in some cases adults) should refrain from such activities. There are also bracelets that warn others that they are suffering an attack, speeding up the process in case of emergency.

Forecast

The prognosis of absence seizures is usually positive. Taking into account that over 65% of children get rid of epilepsy as they grow older, we can be optimistic if we combine this data with successful drug treatment. The only risks that exist with this disease are those that are run with the falls that could occur when suffering a crisis, and we know that the crises that produce this are very infrequent. It is normal for a child to suffer more than ten seizures a day and never fall to the ground or get hurt.

The brain is also not damaged after the absence seizure, so the only interferences can occur in the context of learning, where these periods of loss of consciousness make it difficult to acquire knowledge. Finally, the medication is perfectly removable on a doctor's basis when there have been no crises for two years in a row.