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.

For more information, see:

• Epilepsy
• Seizures
• Generalized tonic-clonic seizure
• Partial (focal) seizure

Alternative Names

Seizure - petit mal; Absence seizure; Seizure - absence

Causes

Petit mal seizures occur most commonly in people under age 20, usually in children ages 6 to 12.

They may occur with other types of seizures, such as generalized tonic-clonic seizures (grand mal seizures), twitches or jerks (myoclonus), or sudden loss of muscle strength (atonic seizures).

Symptoms

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

• Occur many times a day
• Occur for weeks to months before being noticed
• Interfere with school and learning
• Be mistaken for lack of attention or other misbehavior

Unexplained difficulties in school and learning difficulties may be the first sign of petit mal seizures.

During the seizure, the person may:

• Stop walking and start again a few seconds later
• Stop talking in mid-sentence and start again a few seconds later

The person usually does not fall during the seizure.

Immediately after the seizure, the person is usually:

• Wide awake
• Thinking clearly
• Unaware of the seizure

Specific symptoms of typical petit mal seizures may include:

• Changes in muscle activity, such as:
  • No movement
  • Hand fumbling
  • Fluttering eyelids
  • Lip smacking
  • Chewing
• Changes in alertness (consciousness), such as:
  • Staring episodes
  • Lack of awareness of surroundings
  • Sudden halt in movement, talking, and other awake activities
  • May be triggered by hyperventilation or flashing lights, in some cases

Atypical petit mal seizures begin slower and last longer. Symptoms are similar but muscle activity changes may be more noticeable.

Treatment

For information on diagnosis and treatment, see:

• Epilepsy
• Seizures

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.

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