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Childhood absence epilepsy (CAE)

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

Symptoms

The seizures of childhood absence epilepsy usually start between the ages of four to nine years of age, and happen slightly more often in girls than boys. They can also happen many times a day, from 20 up to several hundreds.

A typical absence seizure consists of a sudden loss of awareness. The child will suddenly stop their activities and stare blankly into space. They will be unresponsive to voice. The seizure is sometimes associated with repetitive, purposeless movements of the mouth or eyes (called automatisms). This can include eyelid flickering or fluttering and lip smacking.

A seizure usually last between five and 20 seconds and usually stops as suddenly as it starts, with the child resuming their normal activities.

Absence seizures tend to happen more commonly when the child is bored, sitting quietly or when they are tired or unwell. Conversely, they happen less often when the child is engaged with an activity that they enjoy.

Children with CAE usually develop normally, although uncontrolled absence seizures may impact on the child’s ability to learn at school. Sometimes a child’s concentration or memory is said to be very poor before the diagnosis of the childhood absence epilepsy is made.

Diagnosis

The diagnosis is usually suggested by the history. The doctor may ask the child to hyperventilate (over-breathe) for three to four minutes while counting out loud. This will trigger an absence seizure in over 90 per cent of children with typical CAE, and is important in making the diagnosis.

An electroencephalogram (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 typical CAE.

Treatment

CAE usually responds very well to treatment. The drugs of choice are sodium valproate (Epilim), ethosuximide (Zarontin) and lamotrigine (Lamictal). Occasionally a combination of two of these medications may be required to control absences.

Prognosis (Outlook)

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 antiepileptic drugs.

Approximately 10 per cent of children will develop other seizure types in adolescence, usually generalised tonic-clonic seizures. However these seizures are infrequent and tend to respond to treatment.

Some children with CAE may also develop other seizure types such as myoclonic seizures (sudden, brief jerks). 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 or juvenile myoclonic epilepsy.

Support organisation

Contact a Family
209-211 City Road
London EC1V 1JN
Phone: 0808 808 3555
Website: www.cafamily.org.uk

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This resource is freely available as part of Epilepsy Action’s commitment to improving life for all those affected by epilepsy.

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Code: 
S016.2

 Our thanks

Epilepsy Action would like to thank:
• Dr Richard Appleton, and Dr Rachel Kneen, consultant paediatric neurologists at Alder Hey Children’s Hospital, Liverpool, UK and
• Dr Stewart Macleod, consultant paediatric neurologist at Royal Hospital for Sick Children, Glasgow, UK.
They have kindly prepared the information on this page. It is based on their own research, experience and expertise.

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

  • Updated March 2012
    To be reviewed March 2015

Comments: read the 8 comments or add yours

Comments

My 5 years old son was diagnosed with silent seizure epilepsy 3 months ago and he responded very well to the treatment, epilim. I just wanted to know can he live a normal life as he grow older and also will he cope as a child with school work? Must he drink this treatment forever?

Submitted by Palesa on

Hi Palesa

Thank you for your post.

I’m glad to hear that your son has responded well to his epilepsy medicines. Epilepsy is a very individual condition and affects people in different ways. But with the right treatment seven out of 10 people have their seizures controlled with epilepsy medicines.

Lots of children and adults with epilepsy do live normal lives and because your son is responding so well to the Epilim that is a good sign. Its early days in your son’s diagnosis. But if he doesn’t have any other issues and his seizures are controlled, his epilepsy might not be an issue for his school work.

It will depend on your son’s epilepsy as to how long he will have to take epilepsy medicines for. You could talk to your son’s epilepsy specialist or epilepsy nurse with any questions you have, as they will know more about your son's epilepsy. 

If we can be of any more help please feel free to contact us again either by email or the epilepsy helpline freephone number 0808 800 5050

Kind regards

Vicky

Advice & Information Team

Submitted by Vicky on

I had petit mal as a,child and my 4 year old grandson has unfortunately developed it too. He is on a gradual increase of sodium volporate but the absences are still occurring at the moment. He seems to be very tired and irritable and his concentration levels are often quite poor, could this be a side effect of his medication and if so will it improve in time? His dose is 10mls morning and night currently.

Submitted by lesley marsh on

Dear Lesley

Your grandson’s tiredness, irritability and low concentrations levels may be related to his sodium valproate.

There is more risk that your grandson will get side-effects in the early days of taking his sodium valproate. Once his body has had a few days or weeks to get used to his sodium valproate,  these side-effects should lessen or disappear completely. If they don’t, talk to his family doctor or epilepsy specialist. They may be able to make changes to his sodium valproate to lessen the side-effects. Or if needed, they may change him to a different epilepsy medicine. Here’s a link to our information on anti-epileptic drug treatment.

Once your grandson reaches the right dose of the right epilepsy medicine for his size and bodyweight, there is a very good change the absences will stop.

I hope things settle down for your grandson.

Regards

Diane Wallace

Advice and Information Team

Submitted by Diane on

I have just found out that my son has juvenile absence epilepsy. Please do you have any information on this as the information on your sight is on Childhood absence epilepsy, thanks jo

Submitted by Jo on

Hi Jo

We are just producing a new webpage and factsheet on Juvenile Absence epilepsy. If you either email or phone the Epilepsy Helpline freephone 0808 800 5050, I will send you a draft copy of this information.

Yours sincerely

Diane

Submitted by Diane on

Hi. I was diagnosed with petit mal as a small child and had out grown it by age 5. I am now 56 and have only recently realised that I have really clear memories of this period of my life ( stronger memories than as an older child when I had outgrown this condition). I thought nothing of this until talking with friends who really don't remember anything before 4 or 5 years of age. Could it be that for some reason the brain was more active than normal? Has there been any research in this area? Just thought it was interesting.......

Submitted by Gail Prentice on

Hi Gail

That’s an intriguing piece of information.

There is a lot of research about different types of memory loss and epilepsy. But I don’t know of anything about particularly strong early memories.

Do please let us know if you come across anything.

Cherry

Advice and Information Team

Submitted by Cherry on

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