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Pediatric Absence Seizure Guide

The 5-year-old female is experiencing episodic "blanking out" episodes where she stops activity for 10 seconds and becomes motionless before resuming her previous activity with no awareness of the episode. She experiences 30 episodes per day with no convulsions. An EEG would be performed which would indicate absence seizures. The diagnosis is absence seizures, which typically begin between ages 4-12 and last less than 30 seconds. The first line medication would be Ethosuximide started at 250mg daily and increased gradually as needed. The prognosis for childhood absence seizures is good, with 80% responding to medication, and most children outgrowing the condition without complications or effects on brain development.

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580 views2 pages

Pediatric Absence Seizure Guide

The 5-year-old female is experiencing episodic "blanking out" episodes where she stops activity for 10 seconds and becomes motionless before resuming her previous activity with no awareness of the episode. She experiences 30 episodes per day with no convulsions. An EEG would be performed which would indicate absence seizures. The diagnosis is absence seizures, which typically begin between ages 4-12 and last less than 30 seconds. The first line medication would be Ethosuximide started at 250mg daily and increased gradually as needed. The prognosis for childhood absence seizures is good, with 80% responding to medication, and most children outgrowing the condition without complications or effects on brain development.

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abirami p
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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CASE STUDY ON EPILEPSY

A 5 y/o female is brought to the hospital because of episodic “blanking out” which began 1
month ago. The patient has episodes in which she abruptly stops all activity for about 10
seconds, followed by a rapid return to full consciousness. The patient’s eyes are open during
the episodes and she remains motionless with occasional motionless with occasional
“fumbling” hand movements.

After the episode the patient resumes whatever activity she was previously engaged with no
awareness that anything has occurred. She has 30 episodes per day. No convulsions.

Past medical, physical and developmental histories are unremarkable. No history of previous
or current medications; No allergies, Family history is pertinent for her father having similar
episodes as a child. General physical and neurological examination is normal.

QUESTIONS:

1.What additional studies do you perform, if any?

EEG (Electro Encephalogram) is the most widely used test. This test records
brain’s electrical activity and abnormalities that indicate absence seizure. Blood test, MRI
and CT – but the results will be normal in case of absence seizure. Screening for
attention/behavioural problem is recommended.

2. What is the diagnosis?

The diagnosis is ABSENCE SEIZURE, otherwise called as PETITMAL


SEIZURE. It starts between the ages 4 to 12 years. Usually lasts not longer than 30 seconds.
Here the child’s posture is maintained and after the end of the seizure, the child may not
remember what happened and resume its activity. It may occur several times a day

3.How do you initiate medication? If so, Which?

The first drug of choice for absence seizures is ETHOSUXIMIDE.


Initially 250mg PO daily. The dose may be increased to 250mg every 4-7 days.
The maintenance dose is 20mg/kg/day.
Next drug choice is VALPROIC ACID. Dose is 10-15mg/kg/day. The maximum
dose is 60mg/kg/day.
4. Would you counsel the family regarding prognosis?

The remission rate of childhood absence seizure is good. 80% of the patients respond to
medications. The patient is required to be free from triggering factors, avoid sleep
deprivation, flickering lights and noisy environments. The seizures occurring frequent and
brief last only for a few seconds.

Most children with absence seizure eventually outgrow the condition without complications.
With proper treatment, the child can have a normal life at home and school. There is no long-
term effect on brain development, brain function or intelligence.

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