Are Absence Seizures Absolutely Risky?

Introduction:

A seizure is caused by a brief period of abnormal electrical activity (electrical impulses) in a person's brain. It is a transient clinical event due to abnormal paroxysmal, excessive discharges from a group of central nervous system neurons. The seizure may present in the form of motor, sensory, autonomic, or psychic manifestations. An absence seizure has a generalized onset, meaning it starts on both sides of the brain simultaneously. In this type, there is a sudden loss of awareness characterized by blank staring that lasts for a couple of seconds.

What Are the Types of Absence Seizures?

There are two types of absence seizures. They are:

1. Typical absence seizures.

2. Atypical absence seizures.

In typical absence seizures, the onset is with a blank stare, often mistaken for daydreaming. It lasts nearly 10 seconds and is followed by the return of consciousness.

In atypical absence seizures, the onset is also with a blank stare, but it lasts about 20 seconds and involves other involuntary actions such as lip-smacking, eyelid fluttering, jaw movements, and finger rubbing.

What Are the Signs and Symptoms of Absence Seizures?

Thesigns and symptoms of absence seizures are:

• It occurs mostly in children and ceases after 20 years of age.

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• This is characterized by brief lapses of sensorium with loss of postural control or a blank stare with a loss of awareness.

• They may stop talking mid-sentence or whatever they are currently doing abruptly.

• These are too gentle to be noticed or referred to as daydreaming.

• Multiple episodes may occur in a single day.

• The attacks are much briefer (seconds) and more frequent than complex partial seizures.

• After the episode, there may be confusion, but there is no post-ictal confusion.

• They do not usually cause the typical jerky movements or falls associated with a full-blown seizure.

• There may be mild motor movements like the blinking of eyes, chewing, and hand clonus.

• All these are associated with characteristic EEG (electroencephalogram) patterns.

What Are the Causes of Absence Seizures?

Doctors are not sure of why it occurs in some children. But, it is believed to be hereditary. In some, it seems to be triggered by flashing lights or rapid breathing.

What Are the Risk Factors of Absence Seizures?

1. Age: This particular type of seizure is more common in children between ages 4 and 18 than adults.

2. Sex: It is more commonly observed in girls than in boys.

3. Family History: If you have a blood relative with an absence seizure, the risk increases significantly.

4. Seizures can be precipitated by specific trigger factors. They are sleep deprivation, mental stress, alcohol withdrawal, physical exhaustion, flickering lights such as television or monitor, music, loud sounds, and drug abuse, and such situations should be avoided.

What Are the Complications of Absence Seizures?

1. In most children, absence seizures will go away when they are older. In some, it will continue, or they may have full-blown seizures in adulthood, in which case they will need to continue taking medications.

2. Learning disabilities and difficulty in following instructions at school.

3. Social withdrawal and isolation.

4. It may be considered risky to drive. It is recommended to take public transport if available.

How Are Absence Seizures Diagnosed?

Once a parent, teacher, or friend suspects something to be wrong, it is important to seek expert opinion without further delay. The doctor will recommend an EEG if he suspects a seizure.

How Are Absence Seizures Treated?

First, the patient should be shifted to a safe place, away from danger such as water, fire, and machine. Then, the patient should be turned to a semi-prone position to prevent aspiration. They should not be left alone until the full recovery from seizures as there may be drowsiness and confusion in the post-ictal stage, or the seizures may reoccur. Until the patient is fully recovered, they should not be given to eat. When they continue to prolong for more than 5 minutes or reoccur without the patient regaining consciousness, hospitalization is a must. The doctor may suggest certain medications to prevent the recurrence of episodes. Commonly prescribed drugs include:

• Ethosuximide.

• Lamotrigine.

• Valproic acid.

• Divalproex sodium.

• Clonazepam.

The dose of the drug should be increased gradually until seizures are controlled, or side effects appear. When a single drug does not control seizures, a second may be added while the first drug is gradually withdrawn. In most patients, seizures are controlled with a single drug itself. But in some, a combination of two or more drugs may be needed to control the seizures. The treatment should be continued until there are no seizures for at least 2 to 3 years. During the drug administration, the patient should be monitored for side effects. Blood count, liver function test, and renal function test are done at regular intervals. In order to guide with appropriate dosage and to check the compliance, the serum level of the drug can be measured.

What Are the Preventive Measures of Absence Seizures?

The patient should avoid working with dangerous equipment and should avoid fishing, swimming, and cycling. Also, they should avoid any activity such as driving where the loss of consciousness is dangerous. The patient should avoid working near a fire or at height. All these precautions should be taken until a good control of seizures is obtained. Future episodes can be prevented from occurring by:

1. Taking medicines as prescribed by the doctor.

2. Avoiding all types of stress.

3. Having a nutritious diet.

4. Exercising every day.

Conclusion:

Epilepsy is a brainiac sickness that drives people from having recurring seizures. The seizures occur if the brain's neurons or clusters of nerve cells send out faulty signals. People may experience abnormal senses and feelings or may behave in a different manner. They also have forceful muscle spasms or loss of consciousness. In general, more neurobehavioral disorders could be observed or developed if there is an increased frequency and severe seizures. Neurobehavioral disorders and other abnormal symptoms should be considered during the evaluation of epileptic patients both at the first consultation and during follow-ups.