Epilepsy is a neurological disease that is characterized by the presence of seizures. The crises that are most present in our minds when we talk about epilepsy are those with violent muscle contractions and loss of consciousness.
But they are not the only type of crisis that someone can suffer. Absence seizures, or petit malare much more discreet and physically harmless, but must also be treated.
What is an absence crisis?
Not all absence crises are the same. Due to how fleeting they are, they are often not identified and parents of children who suffer from them take a long time to realize that their child suffers from epilepsy.
Let’s see how absence crises manifest themselves and what can be done with people who suffer from them.
Symptoms
Absence seizures are present almost exclusively in children. They are characterized by a brief period, usually about 15 seconds, where the individual who suffers them seems completely distracted and staring into space. As if he were absorbed in his world. Typical signs and symptoms are:
These crises begin abruptly, in which the patient stops what he was doing or saying, suffers the crisis while maintaining the same posture, and when the crisis is resolved, he continues with the activity he was doing. There is no memory of the episode, 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 may seem like they are simply distracted, many parents become confused and believe that they are just mentally absorbed in something. The first ones to notice are usually teachers, although they may 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 they are absence seizures and not distractibility.
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 begin more slowly and last longer. Furthermore, 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 the electrical alterations 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 repetitive pattern that lasts three seconds.
This predisposition to suffer absence seizures is probably genetic and is transmitted from generation to generation. Some children have seizures when hyperventilating while others have seizures under strobe lights. The exact cause that triggers the attacks is often unknown, but that does not prevent the attacks from being treatable.
Treatment
Once the child goes to the neurologist, it is likely that the diagnosis will be confirmed by provoking a seizure and measuring it through an electroencephalogram. Besides, Imaging tests such as an MRI will be necessary to rule out other diagnoses that may cause similar symptoms and ensure that they are pure absence seizures.
Once the diagnosis is made, children with absence seizures receive pharmacological treatment. Antiepileptic medication is typically used, starting at low doses until the dose necessary to prevent further seizures is reached. Some common antiepileptics are ethosuximide, valproic acid and lamotrigine. Any of the three active ingredients 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 result 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 if you are having an attack, speeding up the process in case of emergency.
Forecast
The prognosis for absence seizures is usually positive. Taking into account that about 65% of children get rid of epilepsy as they grow up, we can be optimistic if we couple this data with successful pharmacological treatment. The only risks that exist with this disease are those that occur with falls that could occur when suffering a crisis, and we know that crises that produce this are very rare. It is normal for a child to suffer more than ten seizures a day and never fall to the ground or hurt themselves.
The brain is also not damaged after the absence seizure, so the only interferences can occur in the learning context, where these periods of loss of consciousness make it difficult to acquire knowledge. Finally, the medication can be easily withdrawn as prescribed by a doctor when there have been no seizures for two years in a row.