Absence epilepsy is a special type of disease characterized by specific seizures without convulsions. Most often, such a pathology is recorded in children, although its manifestation in adulthood is also possible.
Of course, many parents today are interested in more information. Why does childhood absence epilepsy develop? What are the warning signs to look out for? How do seizures proceed, and what provokes them? What are the prognosis for patients? These questions will be answered later in the article.
General information
Absence epilepsy is a specific idiopathic form of this pathology, which in most cases affects young children. The illness is accompanied by absence seizures, which are characterized by a short-term loss of consciousness without the appearance of a convulsive syndrome.
According to statistics, the absence form of the disease accounts for 20% of all cases of childhood epilepsy. The first symptoms appear between the ages of 2 and 8, with girls being more affected.
By the way, for the first timesimilar attacks were described by Tisoot in 1789, but pathology was singled out as a separate nosological form only in 1989.
Abssence epilepsy: causes
The described disease, unfortunately, is registered quite often. So why does absence epilepsy develop in children? The reasons, as a rule, lie in congenital structural defects of the brain. Risk factors also include damage to already formed neurons in the later stages of fetal development. The likelihood of developing this form of epilepsy increases with congenital pathologies such as hydrocephalus and microcephaly.
Don't ignore the genetic factor. Scientists have proven that heredity plays an important role. The congenital instability of the regulation of the processes of excitation and inhibition in the structures of the cerebral cortex is also important.
Harbingers of an attack: what to look for?
As a rule, absence epilepsy begins suddenly, against the background of complete he alth and well-being. Seizures begin spontaneously and are rarely preceded by any symptoms.
However, in some cases, patients note the presence of precursors. So, just before the onset of an attack, they have a headache and nausea, as well as a rapid, strong heartbeat and excessive sweating. Some parents note that before an absence, the child begins to behave inappropriately - aggression or panic appears. You may experience taste, sound and auditory hallucinations.
What does an attack look likechild? Key Features
What are the characteristics of absence epilepsy? The symptoms of this disease are quite typical, although they are not always noticed in time:
- The attack starts suddenly and ends just as suddenly. During a simple absence, the child freezes. Outwardly, it looks as if the patient is thinking about something, but he does not respond to speech or other stimuli. In most cases, the attack lasts about 10-15 seconds. At the end of the absence, the patient does not remember anything that happened during this period. There is no weakness or drowsiness after the paroxysm.
- The so-called complex absence is also possible, to the symptoms of which a tonic component can be added. For example, the patient falls out of his hands, his head throws back, his eyes roll back. Sometimes automatisms are added to the list of symptoms, for example, smacking, stroking hands, repeating individual sounds during an attack.
- In an unfavorable course of the disease, the attack lasts longer, and after it drowsiness and severe weakness appear.
It is worth noting that with this form of epilepsy, paroxysms are repeated often, sometimes up to several hundred times a day, most often during the daytime (when the patient is conscious).
Adolescent epilepsy
It is worth noting right away that juvenile absence epilepsy is accompanied by more pronounced symptoms. Usually the first symptomsbegin to appear around age 10-12.
The attacks are repeated from 5 to 70 times a day. During an absence, the child freezes, his eyes become blank, and there is no reaction. The patient does not remember what happened. An attack can last from 3 seconds to several minutes. By the way, at this age, the classic convulsive syndrome often joins the above-described manifestations of this form of epilepsy.
In more severe cases, a teenager may notice myoclonus veins - uncontrollable rapid blinking. If a child of school age suddenly becomes absent-minded, inattentive, forgetful, then it is worth observing him more carefully and, if necessary, contacting an experienced neurologist.
Absences in adult patients
Absence epilepsy is rare in adults and is usually associated with lack of adequate treatment in childhood or adolescence.
In this case, the absences are characterized by a shorter duration, although the seizures can be repeated many times a day. Eyelid myoclonus and seizures are absent. Nevertheless, the person's consciousness is turned off, and activity is suspended. That is why patients with this diagnosis should not drive, swim unaccompanied, work with complex dangerous mechanisms, since sometimes even a second attack can lead to injury and even death (for example, if a person is driving a car at that moment).
What can trigger an attack?
As already noted,Absence epilepsy is associated with genetic and congenital disorders. However, the appearance of the first attack in a patient, as a rule, is associated with certain conditions:
- strong stress;
- significant physical and/or mental stress;
- change of residence, climate, living conditions, as it is associated with a violation of the adaptive mechanisms of the patient's nervous system;
- injuries, serious illnesses, intoxications, surgeries;
- metabolic disorders, progressive somatic diseases, pathologies of the endocrine system.
In the future, seizures appear more often, and this may be due to exposure to certain risk factors:
- bright light, its flickering (for example, New Year's garlands, bright luminous signs);
- large visual loads (long reading, watching cartoons, computer games);
- strong mental and physical strain;
- sleep disturbance (too much or too little);
- sudden changes in temperature, atmospheric pressure, air humidity.
Diagnostic measures
This pathology is accompanied by very characteristic symptoms, so its diagnosis is rarely fraught with difficulties. The task of the pediatrician and pediatric neurologist is to collect as much information as possible about the symptoms, the presence of genetic or congenital abnormalities, etc. Since the paroxysms will recur often, often the doctorcan personally observe them at the inspection.
Electroencephalography is an obligatory part of diagnostics. It is worth noting that a few years ago this survey was considered a kind of “gold standard”. Nevertheless, during research and statistics collection, it was proved that against the background of absence epilepsy, characteristic changes in the electroencephalogram may be absent, although this is very rare.
Additional tests, such as computed tomography or magnetic resonance imaging, are not necessary to make a diagnosis. Nevertheless, they are carried out if there is a need to exclude the possibility of somatic epilepsy (seizures in such cases are associated with the growth of a cyst or tumor, tuberculosis of the brain, encephalitis and other lesions of the nervous system).
Absence epilepsy: treatment
If you have any alarming symptoms, it is important to consult a specialist in time. After the diagnosis is made, the doctor selects the appropriate treatment regimen. It is worth noting that therapy should take place under the strict supervision of an experienced neurologist or epileptologist.
As a rule, patients are prescribed succinimide drugs (for example, "Ethosuximide"). In most cases, monotherapy is sufficient. If there are tonic-clonic paroxysms, then the doctor may decide to use drugs containing valproic acid (Valparin, Depakin, Depakin-chrono, etc.).
Of course, you need to create a favorable environment for the child - you needavoid stress, carefully plan your work and rest schedule, monitor the quality and duration of sleep, eat right.
Drug withdrawal is recommended only after three years of stable remission. If during this time the attacks do not appear, then you can stop taking the medication. It is also worth noting that barbiturates, as well as drugs from the group of carboxyamide derivatives, should not be taken during therapy, since in this case the likelihood of behavioral and cognitive disorders increases.
Prognosis for patients
This pathology is benign. In about 80% of cases, a stable remission can be achieved (provided that the small patient received timely assistance and underwent an adequate course of therapy).
Sometimes, seizures reappear in adulthood. In such cases, patients are prescribed appropriate therapy. People with a similar diagnosis must follow some safety rules. Until the seizures completely disappear, they are not given a license, they are not allowed to work with potentially dangerous mechanisms, etc.
By the way, small patients with the described diagnosis develop quite normally - cases of physical or mental developmental delays are recorded, but extremely rarely and only with a pronounced malignant course of the disease. However, due to recurring seizures, the child has difficulty concentrating and becomes distracted, which affects his school performance.
