Childhood Absence Epilepsy (CAE), also known as Pyknolepsy, is a common form of idiopathic generalized epilepsy that begins in childhood. CAE is characterized by brief loss of consciousness known as absence seizures. In this article, we will discuss the causes, symptoms, diagnosis and various treatment options available for Childhood Absence Epilepsy.
Causes of Childhood Absence Epilepsy
While the exact cause is unknown, CAE is believed to have genetic predisposition. Research studies have found CAE to have strong hereditary factors, with about 30-50% of cases having a family history of epilepsy. Abnormal brain development and genetics that contribute to abnormal electrical signals in the thalamus and cortex region of the brain are key factors believed to trigger absence seizures in CAE.
Symptoms of Childhood Absence Epilepsy
The primary symptom seen in CAE is absence seizures which are brief lapses of consciousness that last from a few seconds to 30 seconds. During an absence seizure, the child may stare blankly into space and stop responding. Other common symptoms may include:
- Blinking or eye fluttering
- Lip smacking or chewing motions
- Minor twitching movements
- No recollection of the seizure later
- Lapse of attention and responsiveness during seizure
Diagnosis of Childhood Absence Epilepsy
A diagnosis of CAE is made based on a detailed medical history noting absence seizures, neurological examination and EEG or Electroencephalogram. An EEG helps pick up abnormal fast spike-wave discharges in the brain during absence seizures which is the classic diagnostic pattern for CAE. Other tests like MRI scan may be done to rule out any structural causes.
Treatment Options for Childhood Absence Epilepsy
The main Childhood Absence Epilepsy Treatment for CAE involves use of anti-epileptic medications to manage and control seizures. Following are some of the commonly used options:
- Ethosuximide (Zarontin): This is usually the first line medication tried for CAE as it is very effective in controlling absence seizures. Side effects may include nausea, vomiting, drowsiness.
- Valproic Acid (Depakote): Used when Ethosuximide fails to control seizures. Can cause weight gain, hair loss, tremors as side effects.
- Lamotrigine (Lamictal): Also used as alternative to Ethosuximide. Lesser side effect profile makes it preferable for some. Rash is a serious rare side effect.
- Levetiracetam (Keppra): One of the newer anticonvulsants that is used for refractory CAE when above medications fail. Well tolerated overall.
- Dietary therapies: The ketogenic diet, which is high in fats and low in carbs, has shown benefits in some studies for controlling seizures. However, needs long term compliance.
- Vagus Nerve Stimulation: Implanting a vagus nerve stimulator under the skin to deliver mild pulses electrically helps control seizures in some cases where medications fail.
Prognosis and Management of Childhood Absence Epilepsy
The good news is that most children (about 70%) with CAE achieve seizure control with medication within 2 years. Once seizures are controlled for at least 2 years, medication may be slowly tapered off. Long term follow up is needed to check for recurrence. Most people with CAE eventually grow out of seizures by late teen years. However, in about 10% cases, absence seizures may continue into adulthood requiring lifelong medication management. Proper education, avoiding seizure triggers like lack of sleep or fever, compliance to treatment is key to optimize long term prognosis in CAE.
Get more insights on Childhood Absence Epilepsy Treatment
Comments
0 comment