by Childhood absence epilepsy, also known as pyknolepsy or petit mal epilepsy, is a common type of genetic generalized epilepsy that usually begins in childhood between the ages of 4-10 years. While absence seizures can be distressing to witness, effective treatments are available to control seizure activity. This article provides an overview of childhood absence epilepsy and its treatment options.
What is Childhood Absence Epilepsy?
Childhood absence epilepsy is characterized by brief episodes of staring spells, sometimes accompanied by eye blinking or other minor automatic movements. These absence seizures are caused by sudden spikes of electrical activity in the thalamus, a structure deep within the brain. The individual appears conscious but is unaware and non-responsive during the seizure. Episodes typically last 5-30 seconds and can occur many times a day with no memory of the event once it ends. Left untreated, the seizures may interfere with learning and development in children.
Diagnosing Childhood Absence Epilepsy
The diagnosis of childhood absence epilepsy is made based on a detailed medical history and neurological examination by a pediatric neurologist. An electroencephalogram (EEG) test, which records brain wave patterns, is crucial for confirming the diagnosis. During an EEG, people with childhood absence epilepsy will often have generalized spike-wave discharges in the 3-4Hz range seen specifically during absence seizures. Other tests like bloodwork and brain imaging studies are usually normal.
Treatment Options for Childhood Absence Epilepsy
Medication
Ethosuximide is considered the first-line drug treatment for Childhood Absence Epilepsy Treatment. It works by altering how calcium moves within brain cells to prevent seizures. Side effects are generally mild and may include nausea, gastrointestinal upset, or drowsiness when starting the medication. Valproate or lamotrigine can also be effective second-line options. Treatment is usually continued until the child has been seizure-free for 2-3 years, then slowly tapered to see if seizures remain controlled without medication.
Ketogenic Diet
For children who do not respond to or tolerate medication, a ketogenic diet may be recommended. It is a high-fat, low-carbohydrate diet that forces the body to use fat rather than carbohydrates for energy. Following this diet can help control seizures in some cases. Strict adherence is required, and multivitamin supplementation is recommended due to the limited food choices allowed. The ketogenic diet comes with risks and requires management by an experienced dietitian.
Vagus Nerve Stimulation
In rare cases where seizures remain uncontrolled despite trying multiple medications and the ketogenic diet, vagus nerve stimulation (VNS) may potentially help reduce seizure frequency. It involves surgically implanting a device that delivers mild electrical pulses to the vagus nerve in the neck. Safety and efficacy studies on VNS for controlling childhood absence epilepsy are limited, but it may provide benefit for some children.
Prognosis and Outlook
With appropriate treatment, the prognosis for childhood absence epilepsy is generally very good. The seizures typically disappear by adolescence in about 70-80% of cases. Medication should still be continued as advised by the treating physician to prevent seizures from returning. While breakthrough seizures may occasionally occur on treatment, most children with well-managed childhood absence epilepsy go on to live normal, active lives without limitations. Proper treatment can also help minimize disruption to learning and development. Timely and accurate diagnosis along with compliance to the treatment plan are important for achieving the best outcome.
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1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it
