Repeated staring spells, sudden pauses in speech or activity, or no response to being spoken to should be evaluated promptly.
Seizures that happen many times a day or start lasting longer than 20 seconds may be a warning sign of a more serious problem.
Episodes that look like inattention in a child, especially with blinking, lip smacking, or small hand movements, should not be ignored.

An absence seizure is a type of seizure that causes a brief loss of awareness. During an episode, the person may seem disconnected from the world around them, staying still and staring blankly into space.

This type of epileptic seizure is more common in children between 4 and 14 years old, but it can also occur in adults. It happens due to changes in the brain’s electrical activity and in the levels of certain neurotransmitters.

Treatment for absence seizures is guided by a neurologist or pediatric neurologist. It usually involves anticonvulsant medication to help control brain activity and prevent future seizures.

neurologist with brain imaging talking to mother and child

Main symptoms

The main symptoms of absence seizure are:

Sudden loss of consciousness.
Suddenly stopping movement, activity, or speech without falling to the ground.
A fixed, blank stare, as if the person is spaced out or disconnected from the world.
Blinking or rolling the eyes.
Not responding to what is being said or reacting to stimuli.
Pressing the lips together or making chewing movements.

In addition, small movements of the head or both hands, finger rubbing, or paleness may also occur.

Absence seizures can be difficult to recognize, especially in children, and may be mistaken for inattention. According to the National Institute of Neurological Disorders and Stroke, they often cause a person to stare blankly into space, sometimes accompanied by slight muscle twitching.

Because of this, it is important to see a neurologist or pediatric neurologist as soon as symptoms are noticed so the diagnosis can be confirmed and the most appropriate treatment can be started.

How long does it last?

An absence seizure usually lasts about 10 to 20 seconds and can occur many times a day. Afterward, the person typically returns quickly to normal alertness and resumes their activity, without remembering the episode.

However, depending on the type of absence seizure, symptoms may start more gradually and last longer than a few minutes.

Confirming a diagnosis

The diagnosis of an absence seizure is made by a neurologist or pediatric neurologist based on symptoms, health history, and a physical and neurological exam. During the evaluation, the doctor may test behavior, motor skills, and mental function.

To confirm the diagnosis, the doctor may also order an electroencephalogram (EEG) to evaluate the brain’s electrical activity. According to guidance from the National Institute for Health and Care Excellence, the EEG may include provoking maneuvers such as hyperventilation, which can help in assessing a suspected seizure.

Other tests the doctor may order include magnetic resonance imaging (MRI) or computed tomography (CT) scans. These tests provide detailed brain images and help rule out other conditions, such as stroke or a brain tumor.

Possible causes

The main causes of absence seizure are:

Family history of absence seizure.
Age, since it is more common in children between 4 and 14 years old.
Sex, since it is more common in girls than boys.
Rapid breathing.
Sounds, flashing lights, or intense sunlight.
Lack of sleep or emotional stress.
Use of alcohol or illicit drugs.
Lennox-Gastaut syndrome.

In addition, using medications such as isoniazid or antipsychotics, suddenly stopping benzodiazepines, or not taking anticonvulsant medication exactly as prescribed may increase the risk of an absence seizure.

Can childhood absence seizures be cured?

Childhood absence seizures usually begin between ages 4 and 10, with a peak between ages 5 and 7. In many cases, the child naturally stops having these seizures during adolescence, by up to age 18, and becomes seizure-free.

However, some children may continue to have seizures throughout life or may develop other types of seizures.

Different types

The main types of absence seizures are:

1. Typical absence seizure

Typical absence seizure is the most common type and usually involves a sudden pause in activity without warning, with a blank stare or “staring into space” and sometimes eyelid fluttering.

This type of seizure generally lasts about 10 to 20 seconds, and the person may feel briefly confused for a few seconds afterward.

2. Atypical absence seizure

Atypical absence seizure starts more slowly and lasts longer than a typical absence seizure.

In this type of absence seizure, symptoms begin with a blank stare or staring into space, followed by repeated blinking, lip pressing, chewing movements, finger snapping, or hand movements.

Atypical absence seizures usually last 20 seconds or longer and may continue into adulthood. It is more common in people with Lennox-Gastaut syndrome.

Treatment options

Treatment for absence seizures should be guided by a neurologist or pediatric neurologist, who may recommend medications, especially anticonvulsants such as ethosuximide, valproic acid, or lamotrigine.

In addition, to help control and prevent absence seizures, the doctor may recommend a ketogenic diet, which is high in healthy fats and low in carbohydrates. This diet should be followed with guidance from a registered dietitian.

Do people with ADHD have absence seizures?

ADHD and absence seizures are different conditions, although they can have similar symptoms, such as inattention, episodes of staring, or daydreaming.

However, ADHD has other symptoms, such as disorganization, forgetfulness, restlessness, or excessive talking.

In some cases, a person with ADHD may have a higher risk of developing epilepsy and absence seizures, so an accurate diagnosis is important to ensure the right treatment.

Absence Seizure: Symptoms, Causes & Treatment