Tuesday 31 August 2010
Absence seizures (petit mal) Lets talk!
Knowing or suspecting your child has a form of epilepsy can be a very daunting thing, i've set up this site to hopfully give people some information and reasurance about the condition, Absence seizure epilepsy (petit mal). There are thousands of people affected by the condition so feel free to ask questions, post answers, thoughts, comments or expariences here.
Symptoms
During an absence seizure, a child is temporarily unaware of what is happening around him or her. For a few brief seconds, the child stops what he or she is doing, stares straight ahead and does not respond to people speaking. During a seizure, a child's eyelids may blink or flicker very quickly or an arm or a leg may twitch, jerk or move for no obvious reason. After the seizure ends, the child has no memory of the episode and usually resumes previous activities as if nothing happened. Unlike most other types of seizures, there usually is no recovery period after an absence seizure.
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Because a child with absence epilepsy can have many brief seizures during a school day, the disorder may interfere seriously with their ability to pay attention and participate in class. For this reason, a teacher may be the first adult to notice that something is wrong. If the teacher is not familiar with absence seizures, he or she may complain that the child is not paying attention or appears to be daydreaming.Outside the classroom, the child's symptoms may affect the ability to concentrate when he or she plays sports or does homework. Seizures also may interrupt conversations with friends or family members.If you have witnessed any of these types of symptoms, visit your GP as soon as you can. The diagnosis procedure can take weeks to complete so, the sooner you report it to your doctor, the sooner you can get help.
*Please be aware that the seizures can happen at any time so make sure your child is safe whilst on staircases, climbing frames, roads etc. The child can still walk or turn during a seizure and put themselves in serious danger
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Because a child with absence epilepsy can have many brief seizures during a school day, the disorder may interfere seriously with their ability to pay attention and participate in class. For this reason, a teacher may be the first adult to notice that something is wrong. If the teacher is not familiar with absence seizures, he or she may complain that the child is not paying attention or appears to be daydreaming.Outside the classroom, the child's symptoms may affect the ability to concentrate when he or she plays sports or does homework. Seizures also may interrupt conversations with friends or family members.If you have witnessed any of these types of symptoms, visit your GP as soon as you can. The diagnosis procedure can take weeks to complete so, the sooner you report it to your doctor, the sooner you can get help.
*Please be aware that the seizures can happen at any time so make sure your child is safe whilst on staircases, climbing frames, roads etc. The child can still walk or turn during a seizure and put themselves in serious danger
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What is an absence seizure?
The brain's nerve cells (neurons) communicate with one another by firing tiny electric signals. When someone has a absence seizure, the firing pattern of the brain's electric signals suddenly
becomes unusually intense and changes from normal, this is often caused by some of the neurons developing slightly quicker than others causing the two halves of the brain to work slightly out of sync with each other. The seizure can affect only a small area of the brain or it can involve the whole brain. If the whole brain is involved, the electrical disturbance is called a generalized seizure. The two most common forms of generalized seizures are tonic-clonic seizures (often called grand mal seizures) and absence seizures (also called petit mal seizures).They are two very different types of epilepsy and having absence seizures does NOT mean that your child will have a grand mal.An absence seizure causes a loss of consciousness that is usually very brief -- 30 seconds or less -- and barely noticeable, if at all. The person simply stops moving or speaking, stares straight ahead blankly, and does not respond to questions. The seizure is so short and hard to even notice that a person can have 50 or 100 absence seizures a day, without them being detected. When the seizure ends, the person goes back to his or her normal activities without realizing that anything has happened; he or she also does not have any memory of the seizure.Therefore, a child with repeated absence seizures is said to have childhood absence epilepsy or petit mal epilepsy. Although absence epilepsy can begin at any time during childhood, it is most common in children between the ages of 5 and 15 years. Girls have absence epilepsy more often than boys. Although research suggests that genetic (inherited) factors may play some role in the development of absence epilepsy, there is no practical way to use this information to diagnose the disorder or to screen for it.
becomes unusually intense and changes from normal, this is often caused by some of the neurons developing slightly quicker than others causing the two halves of the brain to work slightly out of sync with each other. The seizure can affect only a small area of the brain or it can involve the whole brain. If the whole brain is involved, the electrical disturbance is called a generalized seizure. The two most common forms of generalized seizures are tonic-clonic seizures (often called grand mal seizures) and absence seizures (also called petit mal seizures).They are two very different types of epilepsy and having absence seizures does NOT mean that your child will have a grand mal.An absence seizure causes a loss of consciousness that is usually very brief -- 30 seconds or less -- and barely noticeable, if at all. The person simply stops moving or speaking, stares straight ahead blankly, and does not respond to questions. The seizure is so short and hard to even notice that a person can have 50 or 100 absence seizures a day, without them being detected. When the seizure ends, the person goes back to his or her normal activities without realizing that anything has happened; he or she also does not have any memory of the seizure.Therefore, a child with repeated absence seizures is said to have childhood absence epilepsy or petit mal epilepsy. Although absence epilepsy can begin at any time during childhood, it is most common in children between the ages of 5 and 15 years. Girls have absence epilepsy more often than boys. Although research suggests that genetic (inherited) factors may play some role in the development of absence epilepsy, there is no practical way to use this information to diagnose the disorder or to screen for it.
Diagnosis
The doctor will ask you to describe your child's symptoms, including how often the symptoms occur and how long they last. The doctor will review your child's medical history, especially any history of birth trauma, serious head injury or infections involving the brain, such as encephalitis or meningitis. The doctor also will ask whether any other members of your family have had similar symptoms or have received treatment for any type of epilepsy.The doctor will do a thorough physical, including a complete neurologic examination of your
child, this usually involves testing the childs balance, hand to eye coordination, reflexes and touch sensitivity. This examination may be followed by routine blood tests to check for common medical illnesses that either can mimic epilepsy or trigger seizures. In most cases, the results of your child's physical examination and blood tests will be normal.As a final step in the diagnostic process, your doctor may order an electroencephalogram (EEG). An EEG is a painless test that detects the electrical activity in your child's brain and translates it into a series of printed patterns. A hat with many sensors is placed
on the childs head and readings are take whilst the child carries out simple tasks such as opening and closing eyes and raising an arm or leg. The child will be asked to 'puff' (fast breaths) during the test which will usually bring on a siezure so they can take readings. A strobe light will also be used to see if flashing lights have any affect on the seizures, but this is a less comon trigger with absence seizures. In many children with absence epilepsy, the EEG shows a specific combination of spike and wave patterns that confirms the diagnosis. In some rare cases, the doctor also may order a magnetic resonance imaging (MRI) test or a computed tomography (CT) scan of your child's brain to look for a tumor or other abnormality that may be causing the absence seizures. This may be done if your child has one or more of the following problems: prolonged seizures; an unusual pattern of symptoms or abnormal findings on the physical or neurological examination; or if he or she has had a condition, such as birth trauma, head injury, encephalitis or meningitis, that would put him or her at higher risk of seizures.
Treatment
If your child has absence epilepsy, the doctor will treat the condition with medication, such as lamotrigine (Lamictal) or valproic acid (Depakene, Depakote) The most common treatment is EPILIM (sodium valproate) which will start as 5ml once a day for 2 weeks, then 5ml twice a day for 2 weeks, then 7.5ml twice a day. It usually comes in a syrup form which has a pleasent sweet taste. The purpose of these medications is to control the number of absence seizures your child has and hopefully stop them completely so he or she can reach full potential at school and home. Once your child begins taking a seizure medicine, treatment usually will continue until the child is in their mid-teens when it will be stopped or reduced and more observations will take place.
Prognosis
The outlook is very good. Most children with absence epilepsy eventually outgrow the condition in their mid-teens without complications. With proper treatment, the child can have a normal life at school and at home. In most cases, there is no long-term effect on brain development, brain function or intelligence.
Although the siezures themselves do not cause any damage to the childs brain, there is always a risk of injury during a siezure, as I have found out myself, if a child has a siezure whilst on a staircase or climbing frame it can result in a nasty fall. If a child continues to walk during a siezure then road traffic, walls, sharp objects etc, can be very dangerous.
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