This is an epilepsy syndrome presenting absence seizures that include episodes of staring and change in their state of consciousness. This syndrome can also cause other types of seizures such as tonic-clonic seizures and myoclonic seizures. This usually begins with the late childhood to the early teen years and continues for the rest of their life, hence medication is important in controlling the seizures. It is estimated that around 80% of the cases have controlled seizures with medication.
Cause
The cause of this appears to be predominantly genetic where around one-third of the cases have family members with the history of seizures. Although in most of the cases, the brain will appear normal on the MRI and CT scan imaging, they may actually experience changes in the brain.
Symptoms
This can initially being around the age of 9 and 12 years but could start as early as 5 years. This is characterized by the presence of the individual’s loss of awareness where the child may just stare into the space remaining unresponsive to any types of stimulation. It can also include meaningless actions such as eyelid flickering and lip smacking. Typically this seizure can last for 5 to 20 seconds but can last as long as 45 seconds. This type of seizure may occur particularly when the child is tired or unwell. The episodes can develop several times per day often with exercise. Some of the children may also experience myoclonic seizures and tonic-clonic seizures. They are also at increased risk of absence status epilepticus when the seizures can last for a duration of minutes or hours in some cases presenting problems such as the inability to respond and not walking properly. Although most of these children may develop normally, those presenting very frequent absence seizures can exhibit learning difficulties, memory problems and concentration.
Diagnosis
The diagnosis is based on the evaluation of the child’s history and includes various tests such as EEG to seek possible seizure activity. Most often, the child may be asked to hyperventilate which can trigger the onset of absence seizure in individuals with juvenile absence epilepsy. Some of the children are usually recommended for the screening of the attentional problems.
Treatment
This type of epilepsy usually responds to treatment which occasionally uses a combination of medications. Resistant to the medication has been reported in some of the cases where the various additional investigations may be required such as MRI imaging and genetic tests. As this is a life-long condition, these cases usually require the continuation of the medication to control the seizures. In the case the medication is stopped, the seizure tends to recur.
References
https://www.epilepsy.org.uk/info/syndromes/juvenile-absence-epilepsy
http://www.epilepsy.com/learn/types-epilepsy-syndromes/juvenile-absence-epilepsy
http://www.chp.edu/our-services/brain/neurology/epilepsy/types/syndromes/juvenile-absence-epilepsy
