CAE Absence in Children Epilepsy | Neurology Center NJ

Most people associate seizures and epilepsy with uncontrolled movements. However, epilepsy can also be characterized by a lack of exercise. This form of epilepsy is known as absence epilepsy. Childhood absence seizures (CAE) is an epilepsy syndrome characterized by absence seizures that begin in childhood.

CAE affects 2 to 8% of people with epilepsy. It usually starts in early childhood, between the ages of 4 and 8 years. Most cases are hereditary, although patients with CAE may not have abnormal genetic tests for genes known to be associated with epilepsy. However, our knowledge about genes is constantly evolving, so we may soon have genetic tests that can better identify CAE.

Some people think that absence seizures mean that the seizures don’t show any symptoms. That is not true. In absence seizures, the child who appears absent is the symptom. Generally, during an absence seizure, the child is unresponsive, unconscious, and stares blankly. They may blink or roll their eyes. They may also engage in repetitive behaviors such as mouth chewing.

These attacks are usually short-lived. They last between 10 and 20 seconds. They begin and end abruptly, without any warning to the patient. In fact, most children are unaware that the seizure has occurred and are able to resume their normal activities.

However, most children with CAE have several seizures per day. While CAE generally does not affect normal development, it can lead to problems with attention, concentration, learning, and memory in some children. To understand this, imagine being oblivious to your surroundings several times a day. Inevitably, you would miss information, which could make it harder to concentrate, get lost in the conversation or lesson, and make it impossible to retain the missing information.

If you think your child may have CAE, the next step is a diagnosis. We’ll start with a physical exam to rule out other causes of the staring spells. We can use an electroencephalogram (EEG), computed tomography (CT) scan, or magnetic resonance imaging (MRI) to identify absence seizures.

We can treat CAE with drugs. The preferred first-line treatments are

  • Zarontin/Ethosuximide
  • Valproate/Depakote
  • Lamotrigine/Lamictal

If those first-line treatments are unsuccessful, we can try combining drugs to improve outcomes. We may also use second-line medications, including

  • Topamax / Topiramate
  • Zonegran/Zonisamide
  • Keppra/levetiracetam
  • Clobazam/ Benzodiazepines
  • Stiripentol
  • Symmetrel/Amantadine

The goal is to find the treatment combination that provides the best, most consistent relief with the fewest side effects. Many patients outgrow CAE and require treatment for only a short time.

Neurology Knowledge Center – CAE Epilepsy in child absenteeism

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