Staring seizures are called absence seizures. You may also hear them referred to by their older name, “petit mal” seizures. They cause a brief, sudden lapse in consciousness where a person appears to blank out and stare into space, typically lasting less than 15 seconds. They’re most common in children between ages 4 and 14.
What Happens During an Absence Seizure
An absence seizure starts and stops abruptly. One moment a child is talking or playing normally, and the next they’re staring blankly with a loss of facial expression. Their eyes may drift slightly upward. Then, just as suddenly, they snap back to normal activity as if nothing happened. There’s no falling, no shaking, and no memory of the episode.
Despite how subtle they look, quite a lot can happen during those few seconds. About 86% of people with absence seizures make small automatic movements like lip smacking, chewing, or picking at their clothes. Roughly three-quarters have eye involvement such as rapid blinking or subtle eyelid twitching. These movements are involuntary and stop when the seizure ends.
A child can have 10, 50, or even 100 absence seizures in a single day. Because each episode is so short and quiet, parents and teachers often miss them entirely. A child who seems to “zone out” repeatedly in class or keeps losing track of conversations may actually be having dozens of unrecognized seizures.
Typical vs. Atypical Absence Seizures
Neurologists distinguish between two forms. Typical absence seizures are the more common type: they switch on and off like a light, with an instant return to normal. Atypical absence seizures start and end more gradually, so the transition into and out of the stare is harder to pinpoint. Atypical episodes also tend to involve more noticeable changes in muscle tone, like the head dropping forward, rather than the subtle movements seen in typical absence seizures.
The distinction matters because atypical absence seizures are often associated with other neurological conditions and can be harder to treat. Typical absence seizures, particularly when they appear in otherwise healthy children, generally carry a better outlook.
How They Differ From Other Seizure Types
Absence seizures aren’t the only type that involves staring. Focal impaired awareness seizures (previously called complex partial seizures) can also cause a person to stare blankly and become unresponsive. The key differences help doctors tell them apart.
- Duration: Absence seizures are very short, usually under 15 seconds. Focal impaired awareness seizures typically last longer, often a minute or more.
- Recovery: After an absence seizure, the person returns to normal instantly. After a focal impaired awareness seizure, they’re often confused or dazed for several minutes and may not be able to respond to questions.
- Brain involvement: Absence seizures involve both sides of the brain simultaneously. Focal seizures start on one side.
Common Triggers
Typical absence seizures can be triggered by hyperventilation, which is why doctors often ask a child to blow rapidly during diagnostic testing. It’s one of the most reliable ways to provoke an episode in a clinical setting. Some children are also sensitive to flickering or flashing lights, a phenomenon called photosensitivity. Fatigue, stress, and sleep deprivation can increase seizure frequency as well.
How Absence Seizures Are Diagnosed
The hallmark finding on an EEG (a test that records brain electrical activity) is a distinctive pattern of electrical spikes and waves firing three times per second across both sides of the brain simultaneously. This 3-Hz spike-and-wave pattern is essentially the electrical signature of a typical absence seizure, and it’s what separates absence seizures from focal seizures or simple daydreaming. Doctors can often capture this pattern during the appointment by asking the child to hyperventilate for a few minutes.
Treatment and Outlook
Absence seizures in children respond well to medication. The preferred first-line treatment is ethosuximide, which controls seizures effectively while causing fewer cognitive side effects than alternatives. Valproic acid works equally well at stopping seizures but is linked to greater problems with attention, making it a second choice for most children. A third option, lamotrigine, is less effective than either but may be used when the others aren’t tolerated.
About 65% of children with typical childhood absence epilepsy eventually outgrow it completely, becoming seizure-free and no longer needing medication. This typically becomes clear by adolescence, after an average follow-up period of about 14 years from when seizures first started. The remaining 35% may continue to have absence seizures into adulthood or develop other seizure types, including generalized tonic-clonic (convulsive) seizures.
What to Do if You Witness One
Most absence seizures end on their own within seconds and don’t require emergency intervention. Stay calm, stay with the person, and gently guide them away from anything that could cause injury if they’re standing near a hazard. Don’t restrain them or put anything in their mouth. Once the episode passes, let them know what happened, since they won’t have any memory of it.
Call 911 if a seizure lasts longer than five minutes, if a second seizure follows closely after the first, or if the person has trouble breathing or waking up afterward. These situations are uncommon with absence seizures but require immediate attention.