Childhood Absence Epilepsy

Question 1

Seizure definition

Answer 1

an episode of cerebral dysfunction leading to clinical changes in motor, sensory or autonomic function

Question 2

Simple vs complex absence seizures

Answer 2

Simple: 
Impairment of consiousness
Minimal motor activity
Eyelid fluttering, blinking
Average 100 seizures/day

Complex: 
Impairment of consiousness
Prominent motor activity
Myoclonic jerks, automatisms, atonic 
More common

Question 3

Childhood absence epilepsy

Answer 3

Frequent, short, eyes roll up, flickering of eyelids, changes in autonomic function

5-10 secs

4-12 years of age

Most kids outgrow this

Question 4

Juvenile Absence Epilepsy

Answer 4

4-30 years

Less frequent absence seizures

Question 5

Juvenile Myoclonic Epilepsy

Answer 5

Infrequent absence seizures
GTC and myoclonic seizures (surrounding sleep) are predominant features
No remission but may be responsive to treatment

Question 6

EEG on typical absence

Answer 6

Normal background organization and freq

Ictal discharges (Abrupt onset and offset, Generalized 3 Hz spike and wave, Frontal maximum)

Spikes may become fragmented and irregular during sleep

Question 7

EEG with atypical absence

Answer 7

Often abnormal background with slowing and disorganization

Ictal discharges at 2-2.5 Hz, more irregular

Question 8

Epidemiology of CAE

Answer 8

3-10% of childhood epilepsies

Females > males (60:40)

Question 9

Genetics of CAE

Answer 9

Evidence supporting genetic component but no gene discovered yet

Question 10

Treatment

Answer 10

Anticonvulsants (Zarontin (ethosuximide)) and treat comorbidities

Question 11

Zarontin (ethosuximide)

Answer 11

acts on T-type Ca channels