Absence seizures can appear to observers as though the child is daydreaming or switching off, something we all do when our mind is wandering. Because absence seizures may be hard to distinguish from the child's usual behaviour, they may be difficult to detect. They can occur many times a day and are often mistaken for daydreaming.

In MAE, absence seizures occur in more than one half of the cases. These absence seizures often accompany myoclonic seizures, especially clusters of myoclonic and / or myoclonic-astatic seizures. If these seizures occur frequently throughout the day, they can interrupt the child's ability to function properly because his/her awareness (and the brain's processing) is being constantly interrupted.

What happens?

Like all of the generalised seizures, an absence seizure starts suddenly and without warning.  The child displays a glazed look and stares. Sometimes there is mild twitching of the mouth, eye blinking, or barely noticeable head bobbing which may give the observer a clue that seizure activity is occurring. The event usually lasts only seconds, sometimes 15-30 seconds or perhaps longer, and ends just as abruptly as it started. These events may be so brief that they are observable only on the EEG. When the seizure ends, the child is immediately alert and there is no confusion afterwards. However the child will have missed some of what is happening around him/her.

As is the case with all generalised seizures, the child is momentarily unconscious during the event so he/she doesn't know what is happening, cannot recall anything, is unresponsive and no level arousal will bring them around until the seizure is finished. 

u See also Learning & behaviour

u See also Seizures - atypical absence seizures

u See also Safety - Educating your caregiver

What to do

• Guide the child from danger
• Look for an epilepsy identity card or identity jewellery

• Stay with the child until recovery is complete

• Be calmly reassuring

• Explain anything that they may have missed

Don't

• Restrain the child
• Act in a way that could frighten the child, eg abrupt movements or shouting at them
• Assume the person is aware of what is happening or what has happened
• Give the child anything to eat or drink until they are fully recovered
• Attempt to bring them round

Call an ambulance if....

• The seizure event continues for more than five minutes

• One seizure follows another seizure without the child regaining consciousness between them

• The child is injured during the seizure
• You believe the child needs urgent medical attention¨