The term "petit mal seizures" is an older medical term used to describe what are now called absence seizures. A person having such seizures will look as if he is staring off into space or daydreaming, when in fact, the nerve cells within this person's brain are behaving very abnormally, with excessive electrical activity that results in the seizure.
History
According to the book "Epilepsy: A Comprehensive Textbook," recurrent staring spells--what would today be called absence seizures--were recognized as early as the 14th century. The phrase "petit mal" translates from French to mean "little evil," which distinguished this type of seizure from the convulsive seizure commonly called "grand mal," or "big evil" seizure. During the 1800s, absence and petit mal were used as synonyms. The classic neurology textbook "Adams and Victor's Principles of Neurology" notes that in French, "absence" means "not in attendance" and refers to the way a person looks while having this seizure.
Significance
According to medical database UpToDate contributor Dr. Angus Wilfong, a professor of pediatrics and neurology at Baylor College of Medicine, about 4 to 8 per 1000 children are diagnosed with epilepsy. Among these children, the third-most common type of seizure is absence seizure. Although absence seizures tend to disappear as children reach adolescence, more dramatic generalized convulsions frequently take their place.
Features
Absence seizures are most common in children; Dr. Catherine Lomen-Hoerth, a neurology professor at UCSF, reports in the book "Pathophysiology of Disease" that they often disappear by adulthood. An absence seizure is brief, lasting several seconds. The child having the seizure may look like he is daydreaming, but will not respond when called by name. Blinking, slight head turns, or limb-jerking may occur; posture will not change. A recording of the child's brain waves, called an EEG, will show a pattern called a "three Hertz spike-and-wave;" this indicates to a neurologist that an absence seizure is occurring.
Effects
The textbook "Adams and Victor's Principles in Neurology" reports that a child may have hundreds of absence seizures a day; this may make each school day a major challenge. Such frequent lapses in awareness may also impact social interactions. This limitation, coupled with the poor school performance, may lead to a perception that the child is mentally retarded, when in fact, his IQ is completely normal. Finally, certain situations may be hazardous. One such situation is swimming: an absence seizure while in the water could result in drowning.
Treatments
Treatment for absence seizures generally involves antiepileptic medications. Two medications have been found to be especially effective in treating this type of seizure. Ethosuximide is often used for these seizures. Though its exact mechanism of action is unknown, the Epilepsy Foundation website reports that it suppresses the "three Hertz spike-and-wave" activity seen with absence seizures. Lamotrigine is also used for absence seizures. As with ethosuximide, it is not entirely clear how this medication works. According to the pharmacology database MicroMedex, however, taking lamotrigine decreases the abnormal brain activity associated with seizures, resulting in fewer absence seizures.
References
- "Adams and Victor's Principles of Neurology"; Allan H. Ropper and Martin A. Samuels; 2009
- "Epilepsy: A Comprehensive Textbook"; Jerome Engel Jr. et. al.; 2008
- "UpToDate"; Denise S. Basow; 2010
- "Pathophysiology of Disease"; Stephen J. McPhee and Gary D. Hammer; 2010
- Epilepsy Foundation: Medicine Identification Chart: Zarontin
