//fpnotebook.com/
Absence Seizure
Aka: Absence Seizure, Petit Mal Seizure, Minor Seizure
- Precautions
- Adults with what appears to be Absence Seizures (Petit Mal Seizure) are likely having Partial Seizures
- Epidemiology
- Almost exclusively occurs between age 5 and 18
- Rare before age 2 years or after adolescence
- Causes
- Inherited idiopathic Seizure Disorder
- Secondary Seizure Disorder
- Vascular Malformation
- Infectious disease
- Neoplasm
- Toxic brain disease
- Symptoms and Signs
- Vacant, dazed facial expression
- Staring
- Impaired Consciousness
- Pallor
- Timing of episodes
- Occur Multiple times per day
- Brief interruption of current activity
- Short spells last 10 seconds
- Rhythmic activity
- Eye blinking
- Head movement
- Autonomic symptoms
- Incontinence of urine or stool
- Loss of postural control
- Unusual postictal activity
- Picking at clothes
- Pursing lips
- Differential Diagnosis
- Complex Partial Seizure
- Daydreaming
- Attention Deficit Hyperactivity Disorder
- Diagnosis: Electroencephalogram
- Bilateral, synchronous and symmetric pattern
- Three hertz wave-spike Dysrhythmia over Frontal Lobe
- Course
- Most patients will cease Absence Seizures by age 20
- Absence Seizures began in childhood
- Seizures not due to secondary cause
- Untreated Absence Seizures progress in 33% of patients
- Generalized Tonic Clonic Seizure
- Management: Prophylaxis
- Ethosuximide
- Valproic Acid
- Clonazepam
- Management: Prophylaxis for Children (age <16 years)
- Level A evidence
- Ethosuximide (Zarontin)
- Valproic Acid (Depakene)
- Level C evidence
- Lamotrigine (Lamictal)
- Management: Prophylaxis for Younger Adults (age >16 years)
- Level C evidence
- Carbamazepine (Tegretol)
- Lamotrigine (Lamictal)
- Oxcarbazepine (Trileptal)
- Phenobarbital
- Phenytoin (Dilantin)
- Topiramate (Topamax)
- Valproic Acid (Depakene)
- Level D evidence
- Gabapentin (Neurontin)
- Levetiracetam (Keppra)
- Vigabatrin (Sabril)
- References
- Liu (2017) Am Fam Physician 96(2): 87-96 [PubMed]