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Petit mal seizure

Definition

A petit mal seizure is the term commonly given to a staring spell, most commonly called an "absence seizure." It is a brief (usually less than 15 seconds) disturbance of brain function due to abnormal electrical activity in the brain.

Petit mal seizures occur most commonly in people under age 20, usually in children ages 6 to 12. They can occur as the only type of seizure but can also happen along with other types of seizures such as generalized tonic-clonic seizures (also called grand mal seizures), twitches or jerks (myoclonus), or sudden loss of muscle strength (atonic seizures).

For more information, see:

Alternative Names

Seizure - petit mal; Absence seizure; Seizure - absence

Symptoms

Most petit mal seizures last only a few seconds. Most commonly they involve staring episodes or "absence spells."

The person may stop walking or talking in mid-sentence, and start again a few seconds later. The person usually does not fall. The person is usually wide awake and thinking clearly immediately after the seizure.

"Spells" can be uncommon or occur up to hundreds of times in one day. They may occur for weeks to months before they are noticed, and may interfere with school function and learning. The seizures may sometimes be mistaken for a lack of attention or other misbehavior. Unexplained difficulties in school and learning difficulties may be the first indication of petit mal seizures.

Symptoms of typical petit mal seizures may include:

  • Muscle activity changes
    • No movement
    • Hand fumbling (especially with longer spells)
    • Fluttering eyelids
    • Lip smacking (especially with longer spells)
    • Chewing (especially with longer spells)
  • Consciousness changes
    • Staring episodes (unintentional)
    • Lack of awareness of surroundings
    • Sudden halt in conscious activity (movement, talking, etc.)
    • May be provoked by hyperventilation or flashing lights, in some cases
    • Abrupt beginning of seizure
    • Each seizure lasts no more than a few seconds
    • Full recovery of consciousness, no confusion
  • No memory of seizure

Atypical petit mal seizures begin slower, last longer, and may have more noticeable muscle activity than typical petit mal seizures. There is usually no memory of the seizure. Symptoms may include:

  • Unintentional staring
  • Lack of awareness of surroundings
  • Sudden stop of conscious activity (movement, talking, etc.)
  • Hand fumbling
  • Fluttering eyelids
  • May be provoked by hyperventilation, in some cases
  • May have slower, gradual beginning of seizure
  • Each lasts only seconds to minutes
  • Recovery may be slower
  • May have short period of confusion or bizarre behavior
  • No memory of seizure
  • May change into a different type of seizure (such as a grand mal or atonic seizure)

For more information on diagnosis and treatment, see:

Support Groups

Epilepsy Foundation of America -- www.epilepsyfoundation.org

References

Duvivier EH, Pollack Jr CV. Seizures. In: Marx, JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009: chap 100.

Kornblau DH, Conway Jr EE, Caplen SM. Neurologic Disorders. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, PA: Mosby Elsevier; 2009: chap 173.

Krumholz A, Wiebe S, Gronseth G, et al. Practice parameter: evaluating an apparent unprovoked first seizure in adults (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology. 2007;69:1991-2007.

Schachter SC. Seizure disorders. Med Clin North Am. March 2009;93(2).

Trescher WH, Lesser RP. The Epilepsies. In: Bradley WG, Daroff RB, Fenichel GM, Jakovic J, eds. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa; Butterworth-Heinemann; 2008: chap 71.

Walker SP, Permezel M, Berkovic SF. The management of epilepsy in pregnancy. BJOG. 2009;116(6):758-67.

Review Date: 1/23/2010
Reviewed By: Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; Luc Jasmin, MD, PhD, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles, CA, and Department of Anatomy at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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