Absence Epilepsy In Children: Symptoms And Characteristics

Absence epilepsy is one of the most common forms of epilepsy syndromes found in children. It typically begins between the ages of 4 and 8, with the peak onset around age 5. The condition is more prevalent in girls, accounting for approximately 60% to 76% of cases. Before the onset, children usually experience normal psychomotor development. The primary symptoms include sudden interruptions in consciousness, accompanied by a temporary loss of awareness. These episodes may also involve automatic movements or mild muscle jerks known as myoclonus. Seizures can occur very frequently, sometimes numbering in the hundreds per day.

Diagnosis And Detection

One notable characteristic of absence epilepsy is that seizures can often be triggered by hyperventilation before any anti-epileptic medication is administered. During standard electroencephalogram (EEG) testing, or when using hyperventilation as a provocation method, bilateral symmetrical 3 Hz spike-and-wave discharges are typically observed. This distinct EEG pattern is crucial for accurate diagnosis.

Causes And Genetic Factors

Although the exact cause of absence epilepsy remains unclear, there is strong evidence of genetic influence. It is commonly believed to follow an autosomal dominant inheritance pattern with age-dependent penetrance, although polygenic inheritance is also possible. Research shows that 15% to 44% of affected children have a family history of epilepsy. Family members may experience various seizure types, including absence seizures, myoclonic jerks, generalized tonic-clonic seizures, or febrile convulsions. Additionally, studies indicate a 75% concordance rate for absence epilepsy in monozygotic twins, highlighting the significant role of hereditary factors.

Treatment Options

Currently, valproate and ethosuximide are considered highly effective for treating absence epilepsy in children. However, ethosuximide is not yet available in some regions. For adolescent girls, lamotrigine is often the preferred treatment option, successfully controlling around 80% of seizures. With proper medical supervision, medication may be gradually tapered and discontinued after two to three years of complete seizure control, provided the child's condition remains stable under professional guidance.