T.J. was playing with his sister when all of a sudden he stopped and stared for a few seconds then started playing again. It happened so fast I wasn’t even sure that it really happened. A few days later it happened again but a few times during the day. As I was about to call the pediatrician the phone rang. It was T.J.’s kindergarten teacher. She began to tell me that she had been noticing similar events and that he wasn’t as alert in class, that she would have to give him instructions a few times in order to get his work done. T.J. was seen in the doctor’s office where the neurologist had him blow on a piece of paper. Half a minute later he stopped and stared for a few seconds just like he did at home. He then went back to blowing the paper as if nothing had happened. The neurologist said, “I think he is having absence seizures. Let’s take a look at the EEG”.
Absence seizures are generalized seizures that occur in school-aged children usually between the ages of 5 and 9. Sometimes CAE can be inherited, but it can also occur as a sporadic event. Typical absence seizures consist of sudden cessation of movement, staring, and sometimes blinking. Sometimes, there may be a mild loss of body tone, causing the child to lean forwards or backwards slightly. Unlike other types of seizures, absence seizures occur without an aura or warning. When diagnosing CAE, typical absence seizures need to be differentiated from atypical absence seizures which can occur at an earlier age. An EEG of a child with CAE will show a typical pattern known as 3-Hz generalized spike and wave complexes.
Many children with CAE have normal neurological examinations and intellectual abilities. However, some children may have developmental and intellectual impairments and may have other types of seizures including, but not limited to, tonic clonic seizures.
The prognosis for CAE is excellent. Remission can be achieved in approximately 80% of patients. Close attention must be paid to seizure control to avoid and academic or social difficulties.