Petit mal seizure — also known as absence seizure — is a type of seizure that most often occurs in children. An abnormal electrical discharge in the brain causes seizures. Other types of seizures include grand mal seizure and temporal lobe seizure.
Usually, a petit mal seizure involves only a brief, sudden lapse of conscious activity. Each seizure lasts only seconds or minutes, but hundreds may occur each day. During a petit mal seizure, small jerks sometimes occur involving the facial muscles or hands. A person who experiences a petit mal seizure can usually resume normal activities immediately after the seizure ends.
Repeated seizures characterize a seizure disorder known as epilepsy. Only a small percentage of people who have seizures will develop epilepsy. Medications can be effective in eliminating or reducing the number of seizures.
Signs and symptoms
In a typical petit mal seizure, a brief, sudden absence of consciousness may occur. There may not be any movement at all, only what appears to be staring. In other cases, a seizure may cause:
Lip smacking
Fluttering eyelids
Chewing
Hand movements
Petit mal seizures last only a few seconds. Full recovery is almost instant. Afterward, there is no confusion, but also no memory of the incident.
Petit mal seizures may occur for weeks or months before an adult notices them, because they're so brief. Also, they often occur when a child is sitting quietly and seldom during physical activity.
Because these seizures come and go so quickly, a noticeable decline in a child's learning ability may be the first sign of this disorder. Teachers also may comment about a child's inability to pay attention.
Causes
During normal waking and sleeping, your brain cells produce various electrical discharge patterns. If the electrical discharges by your brain cells become abnormally synchronized, a convulsion or seizure occurs. The abnormal firing of your brain cells can remain localized to a small area or can spread rapidly to involve your entire brain.
Petit mal seizures often affect people younger than 20, and children between the ages of 4 and 12 are most likely to have them. Most children with petit mal seizures have an otherwise normal neurological system. Many can expect to outgrow the disorder. Children who were young when the seizures first started, who have no other neurological problems and who have seizures well controlled by medications are most likely to outgrow their seizures. In about half of children with petit mal seizures, the seizures will progress to grand mal seizures.
Often, the cause of petit mal seizures is unknown. Some of the known causes of this type of seizure include:
Metabolic disturbances. Diseases of the kidney or liver can cause chemical disturbances in your body, as can very low levels of sodium, calcium or magnesium.
Previous brain trauma. Traumatic head injuries, such as those sustained in automobile accidents or serious sports injuries, can cause seizures.
Birth defects. Congenital malformations in the brain can be responsible for seizures in infants and young children.
Family history. In some cases, petit mal seizures run in families.
Traumatic brain injury
When to seek medical advice
Most of the time, no first aid is necessary for a petit mal seizure. If it's the first time you've noticed a seizure, however, contact your doctor.
Also, because petit mal sometimes progress to grand mal seizures, seek immediate medical advice when any of the following occur:
The seizure lasts more than two to three minutes.
A second seizure follows immediately.
The person having the seizure is pregnant.
This is a new type of seizure.
If you see someone having a seizure that produces convulsions or a loss of consciousness, call for medical help immediately and then follow these tips:
Gently roll the person onto one side and put something soft under his or her head.
Loosen tight neckwear.
Don't put anything in the mouth — the tongue can't be swallowed.
Don't try to restrain the person.
Look for a medical alert bracelet, which may indicate an emergency contact person and other information.
Grand mal seizure
Screening and diagnosis
Your doctor may use these diagnostic approaches:
Medical history. Descriptions of your past seizures from you and from family members can help your doctor identify the type and causes of your seizures.
Electroencephalography (EEG). This procedure measures the waves of electrical activity your brain produces. Small electrodes are attached to your scalp with paste or an elastic cap while you lie still. You remain still during the test, but at times you may be asked to breathe deeply and steadily for several minutes or to stare at a patterned board. At times, a light may be flashed in your eyes. These actions are meant to stimulate your brain. The electrodes pick up the electrical impulses from your brain and send them to the EEG machine, which records your brain waves on a moving sheet of paper or digitally on a computer screen.
Magnetic resonance imaging (MRI). Images taken of your brain may help determine what's causing your seizures and can rule out other disorders such as a stroke or a brain tumor.
Blood tests. These tests may reveal a chemical imbalance in your blood or presence of toxic substances. Blood tests may also exclude other causes of seizures.
MRI: Viewing the body's hidden structure
Treatment
Many medications can effectively reduce or eliminate the number of seizures for some people. Finding the right medication and dosage can be complex. You need to take medications on a regular schedule to maintain the proper levels in your blood. Standard medications to control petit mal seizures include valproic acid (Depakene) and ethosuximide (Zarontin). Newer medications that have shown some effectiveness for petit mal seizures include lamotrigine (Lamictal), topiramate (Topamax) and zonisamide (Zonegran). Some seizure medications are associated with birth defects. If you have epilepsy and you're considering becoming pregnant, talk to your doctor.
Most children with typical petit mal seizures can live an active, productive lifestyle and should be encouraged to do so. Your child probably can participate in physical activities and school with few restrictions. There may be some restrictions with driving or operating dangerous equipment when your child gets older.
Many children with petit mal seizures outgrow their seizure disorder. By late adolescence, many people may be able to discontinue their medication under their doctor's supervision. Some people, however, develop grand mal seizures during adolescence and need to continue taking anticonvulsant medication.
Epilepsy
Self-care
Anyone with a seizure disorder should wear a medical bracelet to help emergency medical personnel. The bracelet should state whom to contact in an emergency and what medications you use. It's also a good idea to let teachers, coaches and child care workers know about the seizures.
You may also have to limit activities such as driving, swimming, skiing, working at heights and operating equipment. Doing so may prevent physical harm. Some states have laws requiring such restrictions depending upon how well you're able to control your seizures.
