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Childhood absence epilepsy (CAE)

This is a common epilepsy syndrome starting in early childhood. Absence seizures can happen in many different epilepsy syndromes occurring in childhood and adolescence. This information refers specifically to the syndrome of childhood absence epilepsy.


The seizures of childhood absence epilepsy usually start between the ages of 4 to 7 years of age; rarely the seizures may start under 4, and as late as 8 years of age. They happen slightly more often in girls than boys. They can also happen many times a day, from 10 and up to over 100. They are sometimes divided into ‘typical’ and ‘atypical’ absence seizures.

A typical absence seizure consists of a sudden loss of awareness. The child will suddenly stop talking or what they are doing and stare blankly into space. They will not respond to people talking to them. The seizure is sometimes associated with repetitive, purposeless movements of the fingers, hands or mouth, such as some lip-smacking. These are called automatisms. There may also be eyelid flickering or fluttering.

A seizure usually lasts between 5 and 15 seconds and usually stops as suddenly as it starts, with the child resuming their normal activities.

Absences that last longer than 15 or 20 seconds or that have a lot of automatisms or brief jerks of the head are usually called ‘atypical’ absences.

Absence seizures tend to happen more commonly when the child is bored, sitting quietly or when they are tired or unwell. They happen less often when the child is busy or focused on an activity that they enjoy.

Children with CAE usually develop and learn normally, although uncontrolled absence seizures that happen many times a day may cause some learning difficulties. Sometimes a child’s concentration and memory are thought to be poor before the diagnosis of the childhood absence epilepsy is made – and improves after treatment is started.


The diagnosis is usually suggested by the history. The doctor may ask the child to hyperventilate (over-breathe) for 3 to 4 minutes while counting out loud and sometimes with the eyes shut. If an absence seizure occurs, the child will stop hyperventilating and will open their eyes. Hyperventilation will trigger an absence seizure in over 90 per cent of children with typical CAE, and is important in making the diagnosis.

An EEG test is useful in confirming the diagnosis. The EEG may also be used to monitor response to treatment. No other tests such as a brain scan are required in CAE. If the absences are not controlled with treatment and continue to happen may times a day, children may need to have a magnetic resonance imaging (MRI) brain scan or genetic tests to make sure the diagnosis of CAE is the right one.

Epilepsy Action has more information about diagnosis.


CAE usually responds very well to treatment. The epilepsy medicines of choice are sodium valproate (Epilim), ethosuximide (Zarontin) and lamotrigine (Lamictal). Occasionally a combination of two of these medications may be required to completely control absences. Rarely, the medicines topiramate (Topamax) and zonisamide (Zonegran) might be helpful. Some children may also benefit from the ketogenic diet if their absences are not controlled by any combination of epilepsy medicines.

Information about treatments for children can be found on the Medicines for Children website.

There may be research studies open that are relevant to this epilepsy syndrome. Your child’s doctor will be able to discuss this with you.


The outlook of typical CAE is excellent, with the majority of children becoming seizure free as they pass through puberty.

About 70 per cent of children with CAE will have their absence seizures completely controlled with one or two epilepsy medicines.

Approximately 10 per cent of children will develop other seizure types in adolescence, usually generalised tonic-clonic seizures. However these seizures are infrequent and usually respond to treatment with sodium valproate (Epilim) or lamotrigine (Lamictal).

Some children with CAE may also develop other seizure types such as myoclonic seizures (sudden, brief jerks of the head, limbs or body). When looked at in more detail these children will almost certainly not have CAE but instead have a different epilepsy syndrome such as juvenile absence epilepsy, juvenile myoclonic epilepsy, epilepsy with myoclonic absences or an ‘atypical’ absence epilepsy.


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Website: www.cafamily.org.uk

What is a syndrome?

A syndrome is a group of signs and symptoms that, added together, suggest a particular medical condition. In epilepsy, examples of these signs and symptoms would be things like the age at which seizures begin, the type of seizures, whether the child is male or female and whether they have physical or learning disabilities, or both. The results of an EEG are also used to help identify epilepsy syndromes.

If you would like to know more about an epilepsy syndrome, please speak to your doctor. If you would like to know more about epilepsy in general, please contact Epilepsy Action.


Our thanks

Epilepsy Action would like to thank Drs Richard Appleton and Rachel Kneen (at Alder Hey Children’s Hospital, Liverpool) and Stewart Macleod (at Yorkhill Children’s Hospital, Glasgow), consultants who specialise in children’s epilepsy, who have updated this fact sheet.

This information is exempt under the terms of The Information Standard.

  • Updated February 2016
    To be reviewed February 2019

Comments: read the 31 comments or add yours


My 8 yo son has cae he had been on zarontin syrup 7.5 mls twice a day .But over the last month he has been having more siezures and even been sick and has started to get hot red ears every si often is this normal .He also goes very pale and gets grey looking skin under eyes .is this normal .I am worried .ne help or advice would be great thanks

Submitted by claire on

Hi Claire
I can understand that situation would cause you concern.

Your son’s symptoms aren’t listed as possible side effects of Zarontin. But it would certainly be a good idea to find out why this is happening for him.

I would suggest either making an appointment with your GP or ideally contacting the epilepsy nurse if you have one. Or the paediatrician if you don’t.

I do hope things improve for him very soon.

Advice and Information Team

Submitted by Cherry, Epileps... on

Hi, im from indonesia
This link is bery usefull for me. Big thanks.
I want to ask you some questions
I think my 6 yo daughter have an epilepsy.
It started 3 months ago, when she almost slept, than her eyelid flickering, and her upper body was convulse, if my words not wrong. It was like her upper body vibrating. I than pray for her, didnt think about epilepsy.
Then, yesterday, she got a same symptom. When she get slept at night, suddenly, i see her eyes flickering again, no convulse, but her breath sound roughly and it just 20-30 sec.
This night, same pattern, when she is going to sleep, almost sleep, suddenly, she sit on her bed, but her eyes flickering, cant talk, little spittle on her mouth, 20-30sec, and after that she is crying. She said that she had a nightmare.
Can u give coment for this? Is it an epilepsy too?
How about the prognosis?
Can my daughter get free from it?

Submitted by Eunike on

Hi Eunike

Seeing this happen to someone you love must have been difficult for you. It is good that you are trying to find out what might have caused this to happen to your daughter.

Epilepsy is different for every person. Sometimes a child does grow out of their epilepsy, but for some people it is a lifelong condition. Some of the things you have described can happen to a person when they have a seizure, but this does not mean she has epilepsy. The only person who can diagnose epilepsy is an epilepsy doctor. Maybe you could ask your family doctor to help you find one in the country you are living. This will help you to try to find a cause and get the best treatment for her if she needs it.

You may also be able to find support and information from the Indonesian Epilepsy Association.

Epilepsy Action Advice & Information Team

Submitted by Karen@Epilepsy ... on

My 12 year old daughter has complained for a few years that she can't remember short periods of time or a teacher will be looking at her expecting an answer but she can't remember being asked a question but I thought she was just daydreaming. The other day, I watched her in a ballet class. The music came on but she just stared into space for about 10 seconds while the music played. Then she suddenly looked around & joined in the dance. Then yesterday she said she had her hand up in class & then suddenly the teacher was telling her off for daydreaming. Apparently she had been asked a question but couldn't remember being asked it. I've tried to make an appointment with the doctor but they said they can't see her till next week. Does this sound like CAE? I'm worried that, because I didn't take her seriously, I have made things worse.

Alison Calvert

Submitted by Alison on

Hi Alison
Thank you for your question.

It’s good that once you noticed these events you arranged to see the doctor. If it is a type of epilepsy, you will not have made things worse. With absence and focal seizures it can be difficult to detect them when you’re not looking for them.

As trained epilepsy advisers, we can give general information on epilepsy and related issues. But we’re not able to diagnose your daughter’s symptoms. So it would be best if you, the school and your daughter keep a diary of her events. This will be helpful when you see the doctor. If they think it might be epilepsy, they will usually arrange for your daughter to see an epilepsy specialist at the hospital. This is to make sure she gets the right diagnosis. You may wish to view our information on diagnosing epilepsy before seeing the doctor.

I hope all goes well for your daughter. I’d like to know how she get on at the doctors.

You can contact me either by email helpline@epilepsy.org.uk or the Epilepsy Action Helpline freephone 0808 800 5050. Our helpline is open Monday to Friday, 8.30am until 5.30pm.

Also If we can be of any more help, please feel free to contact us again, either by email or the Epilepsy Action Helpline freephone 0808 800 5050.                                                                                                                                                                  

Diane Wallace
Epilepsy Action Advice and Information Team

Submitted by Diane, Epilepsy... on

I have almost 3 year old twin boys who have both had 1 febrile convulsion each in the last year. Back in the summer we were in the car and when we parked up to get out one of them was just sat there staring & unresponsive, we don't know when it started (as he was in the back) but it continued for about a minute. Then he snapped out of it & started chattering away. Tonight my other son had gone to sleep & I suddenly noticed on the video monitor that he was sat up. I went up & his eyes were open but he didn't respond to me. I turned him to face me & still no response but he seemed a little shaky. I picked him up & gave him a cuddle & laid him back down & he went straight to sleep. Do these sound like absence seizures? I have epilepsy, only diagnosed when I was 38. I don't know if I had any seizures when I was a child & I have no-one alive to ask.

Sorry for the long post xx

Submitted by Karen Convery on

Hi Karen
It sounds like you are doing a really good job of keeping an eye out for how your children are.

I think what you have described sounds enough like seizures for it to be worth discussing with your doctor. I know these episodes only tend to last a very short time, but if it were possible for you to video one, that would be really helpful in diagnosis.

I hope that helps.

Epilepsy Action Advice and information Team

Submitted by Cherry, Epileps... on

Is CAE actual epilepsy or just episodes? Silly question really but am new to all this as my little one has just been diagnoised so still trying to figure it all out

Submitted by Christina maria on

Hi Christina
There is a lot to take in when your child gets a diagnosis. CAE is definitely epilepsy. But the ‘symptoms’ are absences. And once someone is on the right dose of the right medicine there is every chance that the absences will stop.

And as you can see, for most children who are diagnosed with CAE, it is very likely they will grow out of this during puberty.

If we can be of any more help, please feel free to contact us again, either by email or the Epilepsy Helpline freephone 0808 800 5050.

Epilepsy Action Advice and Information team


Submitted by Cherry, Epileps... on

Thank you so much for your reply. He also has hydrocephalus thats treated with a vp shunt. It certainly is alot to take it x

Submitted by Christina maria on

Hi my 6year year old daughter having absence epilepsy started when she was in nursery she is on zarontin syrup I m just worrying about her health since she is taking medicine she become thinner her weight is still same as last year she always complain about headache and legs pain is this because of medicine?she was really chubby girls but now she is to much slim if u tell me my answer I ll be grateful to you.thanks

Submitted by Safina iqbal on

Hi Safina
Weight loss and not feeling as hungry as usual are possible side-effects of Zarontin syrup, so your daughter’s weight changes could be down to her medicine. It’s possible the headaches and leg pain could also be connected, but we’re not medically trained so we can’t say for sure. It’s worth talking to your daughter’s doctor or epilepsy specialist about any unusual symptoms or changes to her general health. They will be able to look into whether it could be down to her medicine.

I hope this helps. If we can be of any more help, please feel free to contact the Epilepsy Action Helpline.

Epilepsy Action Advice and Information Team

Submitted by Grace, Epilepsy... on

Hello again
Thank you for your response. I have finally managed to get an appointment for my daughter to see a specialist. The GP was so supportive & agreed with me that it didn't sound right. We then waited 2 months for an appointment. It happened to be the week I started a new job, so my husband took my daughter. He told the consultant what I had said, but confessed that he'd never seen an episode (he works a minimum of 6 days a week, so he's often not around). My daughter is embarrassed at the thought of having epilepsy & played it down, saying she was 'just thinking', which I know is not the case, as I have witnessed it. The consultant has referred her for an eeg but has written a letter, also sending me copies for the school & drs surgery, saying that it's highly unlikely that Maisie has anything wrong with her at all.
Obviously, if this is actually the case, that would be fabulous, but I think the consultant has completely ignored the fact that both the gp and I felt worried enough about her symptoms to refer her to hospital! I'm really frustrated!
The one positive is that they are still going to carry out the tests, but the consultant said that is only because Maisie is a gymnast, & does a lot of tumbling. Thank goodness that is the case, otherwise she would have been discharged straight away.
I shall keep you informed as to the outcome.

Submitted by Alison Currant on

Hi hope you don't mind but was just wondering how your daughter got on. My daughter has what I think are absence seizures. She sounds just like your daughter. She just blanks out in mid sentence just for a few seconds sometimes i have to remind her what she was saying sometimes she just carries on. It's not affecting her school work , the teachers have never noticed anything. The only time she did something odd at school a group of teachers just laughed at her and told her to wake up! She's 13 now but terrified of doctors so I've never forced her to go as it's not causing any problems. I have said I will take her the minute it does cause any problems or when she's 16 and not grown out if it. I don't fancy her taking medication with side effects when it's not a huge problem! Hope you don't mind me asking how you got on

Submitted by Marianne smith on

The other day my little grandson was standing in the living he suddenly went pure white and very vacant lifted him on to the settee and the colour came back again and at the sides of his face was very blotchy and his arms were limp and his eyes were blinking .
He then fell asleep and was very warm soaking with sweat he has had a few other episodes were he would be white and have blue lips and mottled skin these put down as blue episodes could these be absences very worried as I had a daughter who died aged 24 when she had a seizure shad epilepsy .Sorry for long post

Submitted by Ellen on

Hello Ellen

This sounds like it would have been scary for you.

It doesn’t sound like an absence seizure, but some of what you describe sounds like a focal seizure. Although we’re not saying it is this type of epilepsy, it seems similar to what happens to people who have Panayiotoupulos Syndrome.

When someone is worried about a child we always recommend that they get them checked out by a doctor. It would be worth you all talking to your grandson’s GP about what you have noticed. The GP can then explore what has been happening, and make a referral to a specialist doctor if they feel it is needed.

We would be interested to hear how you get on.


Epilepsy Action Helpline Team

Submitted by Karen-Epilepsy ... on

My grandson attends the paidiatrian for the blue episodes and for low iron but will speak to GP first thank you for your reply will keep you posted Ellen

Submitted by Ellen on

My 7 year old daughter has been seen by the Gp and she has been referred to see a specialist for CAE.
The appointment isn't until for sometime yet :(
I just wondered can anyone give us insight into what the specialist will do on this 1st appointment. I'm assuming they will want a history but that's about it. Will any tests be offered or a trial of medication?
In the meantime my daughters seizure seem to be getting more frequent and lasting longer. Her behaviour since the increase of these seizures seems to have got v challenging too.
Any advice and help would be gratefully received. Just be nice to know some people going through the same as it feels quite a lonely place at times.
Many thanks in advance

Submitted by Jenny on

Hi Jenny

How you are feeling is understandable. It can be a very worrying time waiting for appointments.

We have information on our website about getting the right treatment, questions to ask the specialist and tests for epilepsy

If it will help you to talk to someone, you can phone Epilepsy Action Helpline freephone 0808 800 5050. Our helpline is open Monday to Friday, 8.30am until 5.30pm.

We also have various ways you can contact others who will understand what you are going through. We have our local groups, including coffee & chat groups and we have our forum4e online community,  facebook and twitter.



Epilepsy Action Helpline Team

Submitted by Diane-Epilepsy ... on

My 16 month granddaughter today lolled her head back whilst I was drying her from a swimming lesson and her eyes rolled almost losing all the pupil. it lasted about 4 seconds. She did not go rigid or twitch but was subdued and quiet for the next 5 minutes. I cuddled her and we tested her blood sugar (my daughter is diabetic) but she was 5.1 so we ruled out hypoglyceamia. My daughter said it had happened the previous week with her eyes rolling but she didn't associate it with a problem. We are monitoring her and she is going to ask the health visitor re toddlers eyes rolling . Just wondered if, without any other symptoms this can be sign of some form of epilepsy but appreciate you cannot offer a diagnosis as such. To test a toddler would a EEG be suitable?

Submitted by Gill capaldi on

Hi Gill

It would be a good idea for your daughter to take her to the GP to see if they want to refer her on at this point.

And yes it is possible to give babies and young children EEGs.

Here is all our information about babies and epilepsy.

It would be useful for your daughter to monitor how often this is happening and getting an exact description of what is happening before, during and after these episodes. And if the doctor does suggest your granddaughter seeing a paediatrician, it would be really helpful to see if it is possible to catch one or two of these episodes on video. I know this might feel strange and difficult. But it is definitely the most useful thing if the paediatrician is trying to make a diagnosis.

If we can be of any more help, please feel free to contact us again, either by email or the Epilepsy Helpline freephone 0808 800 5050.



Epilepsy Action Helpline Team

Submitted by Cherry, Epileps... on

My daughter is 8 years old & she is having such seizures from last 4 months, she has similar symptoms as discussed in the forum. We consulted with physiologist for the causes, after few sessions she concluded, my daughter is more mature of her age & hyper active. Physiologist even did IQ test on her as per her treatment process, as a result result her diagnosis is having a IQ of 11 years. I am very much worried. Please suggest.

Submitted by Naveen on

Hello Naveen, 

I can hear that you are worried about this.

It is difficult to tell from your message whether your daughter has been diagnosed with epilepsy or not. If you mean that your daughter has similar symptoms to those listed on the childhood absence epilepsy webpage, then it would be worth you talking to your GP about what is happening. The GP can then refer to a specialist doctor who can explore these symptoms further. 

Some people find it helpful to keep a diary of what is happening to help them explain it to the doctor. Also, if it is safe to do so, you may find it useful to try and get a video of her having one of these episodes. The specialist doctor may find this very helpful. 

I hope that you get some answers for what is happening soon. If you would like to talk about any of this, or have more questions please feel free to get in touch

Epilepsy Action Advice & Information Team

Submitted by rich on

My 6 year old son has been diagnosed with Childhood Absence Epilepsy. We are a week into taking Epilim. He's on a low dose 5ml daily. We only found out 4 days before we saw the consultant that something wasn't right with our son. We pulled in a family favour with the Dr so he was squeezed in. Not much time to prepare or get our heads around it all. We were still in shock to think he could have epilepsy.
What I forgot to ask was is the medication (Epilim) supposed to suppress the seizures completely?
He's still having 3 to 5 a day but they are only lasting 5 seconds now. So we have halved the seizures and reduced how long they are lasting already. We have been given the authority to double the dose next week but unsure if the medication is supposed to stop them completely or just bring it to a level that he can cope with.

Any help or advice would be great.

Submitted by Sarah on

Hi Sarah


Thank you for your question.


It’s good that you have already seen some improvement in your son’s seizures. The aim of his epilepsy medicine is to hopefully stop all of his seizures. It’s usual for the doctors to start a patient on a low dose and gradually increase it. It can take a few weeks or months to reach the maintenance dose (this is the amount of medicine which is thought to work well at controlling seizures). Starting at a lower dose, then gradually increasing it, allows your son’s body to slowly get used to the medicine. This reduces the risk of side-effects.



I hope things continue to improve for your son.


If we can be of any more help, please feel free to contact us again, either by email or the Epilepsy Action Helpline freephone 0808 800 5050. Our helpline is open Monday to Friday, 8.30am until 5.30pm.





Epilepsy Action Helpline Team

Submitted by rich on

Hello everyone, I have a 2 and a half year old daughter who is developmentally delay and goes to speech and physical therapy. A few months ago and recently she will stare out and continue what she is doing in a short amount of time. There have been a few times where she will chew on a corner of a pillow in the middle of being staring out or fidgeting with her pull-up too. She goes to her follow up developmental and behavioural clinic next week and I've been told to tell them about it. My daughter yesterday had a staring out but this time she tilted her head up and her eyes were fluttering for a good 10 seconds and then afterwards acted as if nothing happen. Can someone please tell me what this is or whats going on with my daughter.

Submitted by Karalee Henderson on

Hello Karalee 

Being a parent can be so difficult sometimes, even when you don’t face extra challenges such as these.

Although some of what you describe could be experienced by someone having a seizure, I am not able to tell you whether this is a seizure or not.

When someone is worried about a child though, we always recommend getting them checked out. The best thing would be to speak to your GP about what you have noticed. Your GP may then refer your daughter to a specialist doctor who can try to find a cause for what has happened. Getting her checked out may give you some peace of mind too.

If you are able to capture a video of one of these episodes, this can be very useful  to the doctor as they are able to see what you have seen. It may also be useful when you go to your meeting next week. Some people also tell us that keeping a diary of what is happening helps them to talk to the doctors about it.

If you would like to talk about this, or if we can be of any more help, please feel free to get in touch.

Epilepsy Action Advice & Information Team

Submitted by rich on

when I was a baby back in 1958 I was told later on in life that I had petit mall or now it's called CAE. at two I couldn't walk so I had to have cortisone treatment. by the time I was 7 years old I had my last seizure. because it was congenital i wouldn't pass it on to any children I might have in the future. however, if I married someone with grand mall epilepsy any children I would have would inherit the condition. so in 1986,1989 and 1994, i had three children who are ok no signs of the condition although the doctors had to watch me careful whilst I was in labour with each one, but thankfully I didn't have any seizures. I was told that strobe lighting could trigger an attack so I avoid anywhere that have these. the condition has left me with weakness skills my working memory isn't good and my numeracy skills are not good either. what I'm worried about is that recently I have shown signs of the CAE symptoms might have returned is this possible? sometimes I gaze into space for a few seconds and switch off so to speak. can this return later on in life? if so what do I need to do to be sure? I have been under a lot of stress lately. how do I go about finding out? who do I go and see? is it classed as a learning difficulty? my coordination skills are not good and I can't think of more than one thing at a time otherwise it becomes too overwhelming for me. Any suggestions?

Submitted by susan elizabeth... on

Hi Susan

I can see that would be worrying. It might be a good idea to talk to your family doctor about it. They may well want to refer you back to a neurologist to check what is happening for you. Make sure the GP knows about your co-ordination and other problems as they may also have some thoughts about how to support you with this.

If you do see the neurologist, make sure to check with them whether you have a diagnosis of photosensitive epilepsy. There are not that many people with epilepsy who have this. If you don’t have that diagnosis then you may find strobe lights are not a problem for you.

Here’s our information about memory. Many people with epilepsy have problems with this. Hopefully you will find something useful in there.

Stress is one of the possible seizure triggers people can experience.

I hope you can get a clearer idea of what is happening for you soon. But if it would be any easier to talk about this on the phone do feel free to ring our Epilepsy Action helpline on freephone 0808 800 5050.



Epilepsy Action Helpline Team

Submitted by rich on

My Daughter is 8 years old and has been having seizures since being 18 months and was diagnosed with epilepsy at 3. She originally had once a month a tonic clonic seizure 99 % of the time at night whilst she was asleep. She no longer has his type of seizure but has around 80 absences seizures a day which last for between 5 - 10 seconds. She is currently on Epilim and lamotrigine these seizures don't appear to be controlled what other options are open to be used by her consultants etc. As all that is currently done is increasing the amount of medication she takes which doesn't appear to be helping.

Submitted by David on