Childhood absence epilepsy 

This information is for people affected by or concerned about childhood absence epilepsy, including parents and carers. On this page we talk about how childhood absence epilepsy is diagnosed, what causes it, symptoms, treatment options and long-term outlook.   

Use this page as a general guide and speak to a health professional for more information and support.   

What is childhood absence epilepsy? 

Childhood absence epilepsy is a common type of epilepsy that affects up to 18 out of 100 of all school-aged children with epilepsy. Seizures usually start in children aged between four and ten years. It’s slightly more common in girls than boys.  

Children who have childhood absence epilepsy will have many seizures a day, which could last between five to 15 seconds each. An absence seizure is where you lose awareness of your surroundings for a short time.  

Childhood absence epilepsy is just one type of epilepsy syndrome in a group called ‘idiopathic generalised epilepsies’ or ‘genetic generalised epilepsies’. Other syndromes in this group include:  

• Juvenile absence epilepsy 
• Juvenile myoclonic epilepsy 
• Epilepsy with generalised tonic-clonic seizures alone (GTCA) 

There is some overlap between these syndromes, and your child may go on to develop one of the other types.  

What causes childhood absence epilepsy? 

It’s not known exactly what causes childhood absence epilepsy. But it is thought to be linked to genetics and may run in families.  

More research is needed to understand exactly why this type of epilepsy happens in some children. 

What are the signs and symptoms of childhood absence epilepsy? 

During an absence seizure, children may experience the following symptoms:  

• loss of awareness 
• staring blankly 
• looking like they’re ‘daydreaming’ 
• repetitive facial movements (facial automatisms), for example, chewing or eye blinking.  

Children with childhood absence epilepsy are usually otherwise healthy and developing normally. However, having absence seizures may affect their learning if they are having multiple seizures a day in school. 

How is childhood absence epilepsy diagnosed? 

If you think a child has epilepsy, including childhood absence epilepsy, contact their doctor. You may be referred to a paediatrician (a doctor who specialises in child health).   

Childhood absence epilepsy is usually diagnosed using a combination of: 

• The child’s medical history. 
• A test that triggers seizures by hyperventilation (rapid deep breathing). 
• An EEG (electroencephalogram) test – a painless test that uses small sensors attached to the scalp to pick up the electrical signals produced by the brain. An EEG test will show spikes, mainly in the occipital lobe of the brain (the part involved in processing visual information).  

The specialist doctor will talk to you about any other tests your child may need

Treatment for childhood absence seizures 

If a child has childhood absence seizures, their specialist doctor may suggest trying Ethosuximide (also known as Zarontin) as a first treatment option. Ethosuximide is a medicine that comes as a tablet or solution, that you swallow.  

If Ethosuximide does not work, they may be offered sodium valproate (also known as Epilim) on its own or as an add-on treatment to ethosuximide. Sodium valproate may be offered to the following people: 

• boys of all ages 
• girls aged under 10 years who are not likely to need treatment when they are old enough to have children 
• women who are unable to have children. 

However, there are new rules that apply to valproate treatments (see more information below). The treatment recommendations from NICE (the National Institute for Health and Care Excellence) that relate to valproate are currently being reviewed.   

 If second treatment options do not work, the following treatments can be tried on their own or as add-on options:  

• Lamotrigine (also known as Lamictal) – a medicine that comes as a tablet, that you swallow.  
• Levetiracetam (also known as Keppra) – a medicine that comes as a tablet, liquid or granules, that you swallow or mix with water.  

If one of these medicines does not work, then the other one can be tried. 

Talk to your doctor about switching to a new treatment or adding a new treatment to your child’s current routine. They will explain the reasons for changing treatments, the risks and benefits of each, and any possible treatment side effects. 

Treatment for childhood absence seizures with other seizure types 

If your child has absence seizures with other seizure types (or who are at risk of these), their specialist doctor may suggest trying sodium valproate (also known as Epilim) as the first treatment option. This will be offered to the following people:  

• boys of all ages 
• girls aged under 10 years who are not likely to need treatment when they are old enough to have children. 

In girls with absence seizures and other seizure types (or who are at risk of these) and who can have children, including young girls likely to need treatment when they are old enough to have children, sodium valproate may not be suitable. Read more about the process for prescribing sodium valproate below.

Instead, the specialist doctor may suggest they try the following medicines as first treatment options:  

• Lamotrigine (also known as Lamictal) – a medicine that comes as a tablet, that you swallow.  
• Levetiracetam (also known as Keppra) – a medicine that comes as a tablet, liquid or granules, that you swallow or mix with water.  

If one of these medicines does not work, then the other one can be tried. 
 

If the first treatment options do not work, the specialist doctor may suggest trying the following second treatment options:  

• Lamotrigine (also known as Lamictal) or levetiracetam (also known as Keppra) as second treatment options on their own or as add-on treatment options. 
• Ethosuximide (also known as Zarontin) as a second add-on treatment – a medicine that comes as a tablet or solution, that you swallow.  

If one of these medicines does not work, then the other one can be tried. 

Talk to your doctor about switching to a new treatment or adding a new treatment to your child’s current routine. They will explain the reasons for changing treatments, the risks and benefits of each, and any possible treatment side effects. 

What’s the long-term outlook for people with childhood absence epilepsy? 

The long-term outlook for people with childhood absence epilepsy is generally very good. How old you are when you’re diagnosed with childhood absence epilepsy will determine how likely you are to be seizure-free in later life. For example, around 6 in 10 children with childhood absence epilepsy will grow out of it by the time they reach their early teens.  

For some children, they may develop another syndrome as they get older. These include juvenile absence epilepsy and juvenile myoclonic epilepsy. If this happens, your child may start developing other types of seizures.  

Children with childhood absence epilepsy may experience some problems with their attention, memory and language. They may also be more likely to have depression and anxiety. Talk to your child’s doctor if you’re worried or have any questions. They may be able to refer you to specialist support services.  

Living with childhood absence epilepsy and getting support  

Having a child with any form of epilepsy can be challenging and upsetting. Talk to the child’s doctor for help on how to support them well. And talk to your own doctor if you need support for yourself. If you’re caring for someone with childhood absence seizures, it’s important that you look after yourself and get the support you need.    

You may find it helpful joining an in-person or online support group, where you can listen to or share experiences with other people who understand what you’re going through.