Petit mal seizure

• Alternative Names

  Seizure - petit mal; Absence seizure; Seizure - absence

• Symptoms

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

  The person may stop walking or talking in mid-sentence, and start again a few seconds later. The person usually does not fall. The person is usually wide awake and thinking clearly immediately after the seizure.

  "Spells" can be uncommon or occur up to hundreds of times in one day. They may occur for weeks to months before they are noticed, and may interfere with school function and learning. The seizures may sometimes be mistaken for a lack of attention or other misbehavior. Unexplained difficulties in school and learning difficulties may be the first indication of petit mal seizures.

  Symptoms of typical petit mal seizures may include:

  • Muscle activity changes
    • No movement
    • Hand fumbling (especially with longer spells)
    • Fluttering eyelids
    • Lip smacking (especially with longer spells)
    • Chewing (especially with longer spells)
  • Consciousness changes
    • Staring episodes (unintentional)
    • Lack of awareness of surroundings
    • Sudden halt in conscious activity (movement, talking, etc.)
    • May be provoked by hyperventilation or flashing lights, in some cases
    • Abrupt beginning of seizure
    • Each seizure lasts no more than a few seconds
    • Full recovery of consciousness, no confusion
  • No memory of seizure

  Atypical petit mal seizures begin slower, last longer, and may have more noticeable muscle activity than typical petit mal seizures. There is usually no memory of the seizure. Symptoms may include:

  • Unintentional staring
  • Lack of awareness of surroundings
  • Sudden stop of conscious activity (movement, talking, etc.)
  • Hand fumbling
  • Fluttering eyelids
  • May be provoked by hyperventilation, in some cases
  • May have slower, gradual beginning of seizure
  • Each lasts only seconds to minutes
  • Recovery may be slower
  • May have short period of confusion or bizarre behavior
  • No memory of seizure
  • May change into a different type of seizure (such as a grand mal or atonic seizure)
• Support Groups

  Epilepsy Foundation of America -- www.epilepsyfoundation.org

• References

  Foldvary-Schaefer N, Wyllie E. Epilepsy. In: Goetz CG. Textbook of Clinical Neurology. 3rd ed. Philadelphia, PA: Saunders Elsevier; 2007:chap 52.

  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.

  Pollack CV Jr. Seizures. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. Philadelphia, PA: Mosby Elsevier; 2006:chap 100.

  Spenser SS. Seizures and epilepsy. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, PA: Saunders Elsevier; 2007:chap 426.

  Tomson T, Hiilesmaa V. Epilepsy in pregnancy. BMJ. 2007;335:769-773.

Review Date: 3/28/2009

Reviewed By: Reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Previously reviewed by Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. (6/19/08)