Childhood absence epilepsy is a common type of epilepsy in school-aged children. It causes frequent, brief seizures called absence seizures. Most children with childhood absence epilepsy develop normally and respond well to medicine. Many stop having seizures as they grow older. Early recognition and treatment can improve learning and quality of life. Ongoing support for attention and behavior is often important for children and caregivers.

Childhood absence epilepsy is a type of epilepsy that causes frequent absence seizures in otherwise healthy children. These seizures are brief episodes of reduced awareness that may look like staring spells. They usually begin between ages 4 and 10, most often around ages 6 or 7. Childhood absence epilepsy is one of the most common forms of epilepsy in children, accounting for about 10% to 18% of new epilepsy cases in this age group.

Absence seizures were formerly called petit mal seizures. During these episodes, children may suddenly stop what they are doing, stare blankly, and become unaware of their surroundings for several seconds. The seizures often end abruptly, and the child resumes normal activity without remembering the event.

Most children with childhood absence epilepsy develop normally, but some may have attention or learning difficulties. The condition is more common in girls than boys. Before treatment, seizures can occur many times each day, sometimes 50 times or more. In most cases, absence seizures disappear during adolescence, but some children may develop other types of seizures later.

Childhood absence epilepsy is mainly caused by changes in several genes and their interaction with environmental factors. Most children with childhood absence epilepsy do not have a single gene change that causes the condition. Instead, they may have a combination of gene changes that together increase the risk.

Many genes linked to childhood absence epilepsy affect proteins that help control electrical signals in the brain. Changes in these genes can make certain brain cells more excitable, leading to seizures. Rare changes in other genes may also play a role, especially when seizures begin at an unusually early age or do not respond to medicine.

Family studies show that first-degree relatives, such as parents and siblings, have a higher chance of having absence seizures. However, most children with childhood absence epilepsy do not have a family history of epilepsy. Environmental factors may also contribute, but their exact role is not fully understood.

Risk factors for childhood absence epilepsy include genetics, family history, and sex. The main risk factors are:

• The condition is more common in girls than in boys. About 60% to 75% of cases occur in girls.
• A family history of absence seizures or other generalized seizures (seizures that affect both sides of the brain from the beginning) increases the risk.
• Siblings of children with childhood absence epilepsy have a slightly higher chance of developing epilepsy.
• Certain gene differences that affect electrical activity in the brain may increase the risk, although most children do not have a single identifiable gene change.

Symptoms of childhood absence epilepsy mainly involve frequent, brief absence seizures, but other signs and problems can occur. Symptoms may include:

• Sudden staring spells, in which the child stops activity and appears unaware for several seconds
• Loss of awareness during the seizure, with no response to people or surroundings
• Repetitive movements during the seizure, such as blinking, eyelid fluttering, or chewing movements
• Seizures that begin and end abruptly and usually last four to 20 seconds
• A return to normal activity immediately after the seizure, with no memory of the event
• Multiple seizures each day, sometimes 50 or more before treatment
• Learning difficulties or problems with attention or memory, especially if seizures are frequent or last longer
• Anxiety, mood changes, or mild language and fine motor skill difficulties, such as difficulty writing or fastening buttons

Generalized tonic-clonic seizures (seizures with muscle stiffening and jerking) are rare before puberty but may develop later in some children.

Doctors diagnose childhood absence epilepsy based on a careful review of symptoms and medical history, a physical and neurological examination, and specific tests.

A doctor will ask about the child’s seizure episodes, including how often they occur, how long they last, when they began, and whether the child has other health or learning problems. Descriptions from parents, teachers, or caregivers are important because they can explain what happens during the episodes. The doctor will also assess the child’s development and perform a physical exam that checks movement, coordination, reflexes, and other functions of the nervous system.

Most children with childhood absence epilepsy have a normal examination. However, the doctor will look for developmental delays, unusual movements, or other signs that may suggest a different diagnosis.

Medical tests used to diagnose childhood absence epilepsy include:

• Electroencephalogram (EEG): This test records electrical activity in the brain. It can help confirm that the episodes are absence seizures. During the test, the child may be asked to breathe rapidly and blow on a pinwheel or look at flashing lights to help bring on a seizure.
• Video-EEG: This test records the child on video while an EEG records the brain’s electrical activity. It may be used when the diagnosis is unclear.
• Screening for attention and learning problems: This screening can identify problems that may require support.
• Brain imaging with computed tomography (CT) or magnetic resonance imaging (MRI): Brain imaging is usually unnecessary when the symptoms and EEG results are typical. A scan may be recommended if there are unusual findings or concerns about other conditions.
• Genetic testing: These tests may be considered if seizures begin before age 4, the child has developmental delays, or the seizures do not respond to medicine.

Treatment for childhood absence epilepsy focuses on controlling seizures and supporting learning and behavior. Most children respond well to medicine. Treatment options include:

• Ethosuximide: This medicine is usually tried first to treat absence seizures. It is effective for most children and has fewer attention-related side effects than some other medicines.
• Valproic acid: This medicine may be used if ethosuximide does not control the seizures or causes troublesome side effects. It may also be used if the child has other seizure types, such as generalized tonic-clonic seizures. It is as effective as ethosuximide but may cause more attention problems and weight gain.
• Lamotrigine: This medicine may be used if valproic acid is not an appropriate option. However, it is less effective than ethosuximide or valproic acid.
• Combination therapy: If two medicines used separately do not control the seizures, using two medicines at the same time, such as valproic acid and lamotrigine, may help. Careful monitoring for side effects is needed.
• Other medicines: Other medicines may be considered when the usual treatments do not control the seizures, including zonisamide and benzodiazepines, among others. Evidence supporting these medicines is limited.

Some medicines can worsen absence seizures or do not work for this type of seizure. A doctor will choose a medicine that treats absence seizures.

Treatment usually continues for at least two years after seizures have stopped.

Complications of childhood absence epilepsy can affect learning, behavior, and seizure control. The main complications include:

• Attention deficit hyperactivity disorder (ADHD): Many children have attention problems that may continue even after seizures are controlled.
• Learning difficulties: Frequent seizures or longer seizures can lead to problems with school performance and memory.
• Later development of other types of epilepsy: A small number of children may develop juvenile myoclonic epilepsy or another form of epilepsy as they grow older.

The outlook for childhood absence epilepsy is excellent. Most children will have their seizures controlled by medication. The medicine may then be gradually stopped after the child has been seizure—free for at least two years. Some children may continue to have absence seizures or develop other seizure types, such as generalized tonic-clonic or myoclonic seizures.

Early diagnosis, effective treatment, and support for related attention, learning, or behavioral problems can improve quality of life and long-term outcomes.

This article was medically reviewed in August 2026.