A short-term loss of connection with reality, loss of consciousness without seizures in children is perceived by parents as something unknown and strange. There were times when such phenomena were considered signs of possession and unusual paranormal abilities. In fact, we are talking about absences.
What it is?
Absans got its name from the beautiful French word absence, which translates as “absence”. This refers to the absence of consciousness for some time. An abscess in medicine is a small seizure, very similar to an epileptic one, but not accompanied by convulsions. Absancies are the clinical manifestations of such a non-convulsive seizure.
Such epilepsy without seizures was known to doctors of antiquity, in particular, it was described by Hippocrates, who called the disease "a sacred disease." After the great doctor Hippocrates, a strange epilepsy, which is not associated with seizures, but only manifests itself as loss of consciousness and twitching of the eyes, was described by the Swiss doctor Samuel Tissot in the 18th century. A century later, absences were studied by the French psychiatrist Eskirol and his students.
Until now, scientists and doctors argue about what is, in essence, absences. But for the most part, doctors are in solidarity in the opinion that this is a separate epileptic form. She, of course, can accompany the usual epilepsy, and can be observed separately.
These seizures without seizures are common in children after 4 years of age, most often at the age of 4-7 years, a little less often at the age of 7-14 years, it is quite rare that absences start after 15 years. More common in girls and girls than in boys and young men. In infants under one year old, this phenomenon practically does not occur due to the immaturity of the cerebral cortex (the fact is that a certain degree of maturity of the brain and nervous system is needed for absence).
Causes
Doctors still argue about the true reason for absences. So far, it is believed that the lack of balance between the processes of inhibition and excitation of nerve cells in the cerebral cortex is to blame for everything. Hippocrates suspected such a reason, and the research of his followers did not bring anything essentially new to the questions of the origin of absences.
The following factors can lead to an imbalance between the impulses of inhibition and excitation in neurons.
- Organic brain damage: transferred encephalitis, brain abscesses, as well as tumors and neoplasms. Such absences are called secondary, that is, those that occurred as a complication of the underlying pathology.
- The reasons, medicine and science are unknown and incomprehensible Are idiopathic absences. There is a version that they depend on genetic information and usually occur in children whose family has had cases of epilepsy. There is also a version that such absences can develop in children who at an early age experienced episodes of febrile seizures (against a background of high fever), but this connection has not yet been reliably proven.
Absances start under the influence of certain triggers, which have not been established for certain by medical science either. It is believed that too fast and deep breathing, which leads to hypervertilation of the lungs, in particular, can cause an attack. Also, flashes of light, for example, a flashlight or bright fireworks, can provoke paroxysm.
It is believed that the likelihood of seizures is higher in children who are sleep deprived, as well as during periods of anxiety, stress, and severe physical and psychological stress.
What happens and the types of seizures
Absancies can rightfully be considered the most mysterious pathology, since the mechanisms of the development of seizures are also a secret behind seven seals. Many scholars believe that such a non-convulsive seizure is based on the predominance of inhibition in the cerebral cortex, while a convulsive epileptic seizure is usually associated with excessive neuronal excitation. The version of the importance of such seizures for compensating for certain processes in the child's brain also looks very reliable, which is why, in most cases, there is no trace of absences left by the age of majority - the brain matures completely.
The absences themselves are divided into simple and atypical. Simple (they are also typical) proceed with short episodes of loss of consciousness - literally for half a minute. There are no other symptoms in typical absences. In most cases, the child during such a seizure can continue the work he started before the seizure, but his actions are very slow, inhibited. Difficult absences (they are also atypical) occur with a change in the state of muscle tone. The seizure lasts 5 to 20 seconds, usually accompanying an epileptic seizure.
Symptoms and Signs
Typical and atypical absences manifest themselves in different ways. Simple, as already mentioned, are accompanied only by short-term loss of consciousness. The attack comes suddenly, nothing foreshadows it, there are no harbingers. It's just that a child who was playing or was busy with a conversation suddenly stops moving quickly, “turns to stone”, looks straight in front of him, the facial muscles do not contract, therefore the child's facial expression does not change throughout the attack. Baby can not react to external stimuli in any way - voices, sounds, light. After about half a minute, the condition returns to normal. The child does not remember the attack, for him these half minutes seem to fall out of life.
Such paroxysms can be repeated several times a day and several times a month. At a high frequency, typical seizures reach a frequency of several tens per day. Each lasts no more than half a minute, the child with open eyes is in a detached state, external stimuli do not take him out of the attack. Such typical seizures on the electroencephalogram are marked as a peak wave with a certain frequency - 3 Hz.
With atypical absences, the child not only loses consciousness during the attack, but other phenomena occur, which are the same for a particular baby every time. For example, with the same movements of the lips, tongue, some kind of repetitive gesture, constant correction of the hairstyle. That is, the child continues the action, even being unconscious, which is why such paroxysms often go unnoticed for a long time.
Very often, atypical absences occur against the background of changes in muscle tone. The child can move his head back with rolling his eyes, or he can bend back and at the same time maintain balance due to the leg laid back. If the tone changes in the direction of hypotonia, a fall is still inevitable, since the muscles, regardless of posture, quickly weaken.
Often these attacks are accompanied by gustatory, auditory, or visual hallucinations. The child remembers the attack itself, but regards as something unusual what has just happened to him and that he cannot explain.
The development of persistent epilepsy can be a complication of absences. This happens in about one in three children with periodic absences. A child may be injured if they fall during a difficult attack. Sometimes the presence of absences leads to deviations in the mental and mental development of the child.
What to do?
If parents notice such "oddities" in their child, it is important to turn to a pediatric neurologist in time, who will help establish whether there are absences and what is their reason. A neurologist examines the child, but in non-epileptic absences (idiopathic), no neurological abnormalities are usually detected.
The child is recommended to undergo an EEG (electroencephalogram), in some cases it is recommended to have an MRI of the brain to exclude tumors and organic lesions.
Treatment is prescribed only after doctors can determine whether the child has underlying diseases or not. From this, in fact, therapy will depend. Children with simple absences are advised to take valproic acid preparations - in about 75% of cases, treatment is effective.
Complex absences require the use of anticonvulsants. Antiepileptic therapy lasts as long as the doctor deems necessary, the dosage is then reduced gradually. Usually, to cancel the drug, indications are needed, for example, the absence of seizures for 2-3 years.
Folk remedies, conspiracies, osteopathy for absences does not exist, parents should not forget about this.
In most cases, the forecasts are favorable: absences are a thing of the past when the child grows to 18-20 years of age. If the first attacks appeared in adolescence, then the probability that a person will "take" them with him into adulthood is estimated at about 25-30%. Alas, the forecasts are not very favorable, if absences appeared too early, they recur if they proceed with mental retardation, memory impairments, thinking.
The specialist tells in more detail about children's absences in the video below.
