Charles Ribak, Ph.D. (Professor of Anatomy and Neurobiology, UC Irvine School of Medicine) gives expert video advice on: What should I do if I think I'm going to have an absence seizure?; What should I do if I see someone having an absence seizure? and more...
What is an "absence" seizure?
An absence seizure is a temporary loss of consciousness. It doesn't mean that the person falls down or they are going to have their head drop to one side. It could simply be their eyes moving up into their sockets and rolling up into their sockets. Then, within 5 to 10 seconds, they are totally conscious and aware of what's going on. The absence seizure was previously referred to as the "petee mal" or the "petit mal".
Who is most at risk for having absence seizures?
Absence seizures usually occur in young children in grammar school. In fact teachers mainly notice this in the students, more so than the parents do. Therefore it's so very important for parents to trust the teacher. The teachers have seen these absence seizures, and therefore they are pretty good at picking them up from children.
What triggers an absence seizure?
We really don't know what the trigger for an absence seizure is. The trigger for an absence seizure probably relates to the brain region that we talked about, the thalamus and the role that the thalamus plays in activating large portions of the cerebral cortex.
What happens to the brain and body during an absence seizure?
During an absence seizure, usually the posture of the body remains pretty much upright. The head also remains in an upright position. However, the eyes may blink several times and the eyeballs may actually move up into the orbit. For the most part these are the only outward appearances of this type of seizure. If you were to ask the person during the absence seizure a question, they would not respond. We don't know whether this is because they can't hear it, or they are unable to actually speak.
What are the dangers of absence seizures?
It's very important to get treatment for the individual experiencing absence seizures. A typical sufferer is a young child below the age of ten, and the absence seizures have a tendency to increase in number if they are not treated. I think it's probably most important that they be treated. For example, if one is involved in some activity and an absence seizure hits, they might not be aware of a car in the neighborhood, and they could get hit by a car. There are certain risks with absence seizures, and certainly this individual should be treated.
What treatments are available to a person who has absence seizures?
For the child with absence seizures (absence seizures are also referred to as petit mal), these seizures are best treated by ethosuxomide-type drugs. The one that's out there on the market is name brand Zarontin, and this seems to at least decrease the frequency of these absence seizures. The best thing, really, is to keep an eye on your child when they are under your supervision at home while they're awake, and make sure they don't get involved in doing activities where they could injure themselves if they did have a seizure. And also, I would continue to maintain strong lines of communications with their school teacher and discuss, on a weekly basis, whether or not the teacher has noticed the seizures are less frequent, based on the use of this medicine that they're on.
What should I do if I think I'm going to have an absence seizure?
This would be very rare. It's very difficult to actually have a warning for an absence seizure. Auras, the so-called sensory warnings that we talked about in an earlier question, are not associated with this type of a seizure. So, this is a difficult question to answer, because it may not be applicable to this type of epilepsy.
What should I do if I see someone having an absence seizure?
The most important thing is to report it to that person when the absence seizure is over, or report it to their parents or report it to the principal of the school if you're a teacher and this is a school classroom. I think that's probably the most important thing. You may want to have that person just stay in one place for awhile, sit and observe them to see if more of these seizures occur. But I think for the most part, just reporting it and recommending that the individual go to a doctor.