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What Is an Absence Seizure aka Petit Mal Seizure?

Learn about the generalized absence seizure, or petit mal seizure, from Steve Wolf, MD and Patty McGoldrick, NP in this Howcast video.


Patty McGoldrick NP, MPA: So absence or petit mal seizures as they used to be called are a form of generalized seizures. So again, the whole brain lights up with electricity all at once. They often present in childhood, usually around six to eight years old, maybe a little older, but we've had kids as young as three or four presenting with it. So they look like a sort of eye roll or an eye deviation and a staring spell.

Steve Wolf MD: I'll act it for you. So they could be talking to you, and suddenly they'll. . . [pause]. . .What did you say?

Patty: Right. And it's more than just your child not paying attention to you. And this goes on repeatedly, and then you realize after a while that they're sort of missing things. And they occur in all situations. They occur watching TV, watching movies. They occur during a conversation. So you have to really weed out and say to the parents when they come in, "Does this only happen when they're watching TV? Or does it only happen in school when the lesson is something they don't understand?"

Steve: And there short. They're like three to five seconds sometimes. It can be very easy to miss them. Sometimes the teachers pick them up. But you know, it's hard to differentiate from daydreaming. How do you do that?

Patty: Well that's when you bring them in and you do an EEG, because it has a very distinct pattern on the EEG.

Steve: But the most important part on the EEG is if you don't capture the episode of the staring spells, then you haven't made the diagnosis.

Patty: So on the EEG, there is a pattern that's called 3-hertz spike and wave, and if you look at the EEG you see this big burst of electricity that lasts for a few seconds, and it's across the whole EEG. The problem is that if you do a short EEG for 30 or 40 minutes, you may not get one of these events, and you may not see the abnormality. Because the EEG otherwise is perfectly normal.

Steve: But we tell families that this is like one of the better epilepsies, because it has the highest chance of outgrowing it. But if you don't treat it, it really can affect things academically. You worry about kids walking down the block, not you know walking into the street because they'll zone out, falling down the stairs if they zone out. So it's important to treat.

Patty: It is important to treat, and it's very important to treat as the kids get older and they're taking subways or buses alone, or they're driving cars, because you don't want them to have an absence seizure or a staring spell in the middle of that. So again, absence seizures are a form of generalized seizures. The electricity lights up in the whole brain all at once. They're short. They can happen many times a day. They may not happen every hour, so they may not be captured on a short EEG. They're very treatable, and it's very important to treat them so a, the child doesn't get hurt, and b, that the child is not missing information in school and doing poorly academically.

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