Childhood Absence Epilepsy (CAE)

19th November 2018

Childhood Absence Epilepsy (CAE) is an epilepsy syndrome that often starts during early childhood between the ages of 4 and 7. It’s very rare for this particular epilepsy syndrome to start any earlier or later than these ages, although not entirely impossible. The syndrome is considered to be slightly more common in girls than boys.

Symptoms of CAE

Seizures as a result of CAE can happen many times a day, often as many as 10 to 100. Seizures may be either typical or atypical, often a mixture of both throughout the course of a day.

Typical absence seizures

These types of seizures will result in an unexpected loss of response and awareness from the child, which will result in loss of speech. The child will appear vacant and likely stare into space. It’s also possible that the child will start to make repetitive movements with various parts of their body, such as the fingers or hands, these are called automatisms. A typical seizure is brief and is usually over just as quickly as it begins within approximately 15 – 20 seconds.

Atypical absence seizures

An atypical absence seizure will display all of the same signs as a typical seizure, however, an atypical seizure will last longer than 15 – 20 seconds and almost certainly contain automatisms and jerking of the head.

It has been noted that both typical and atypical absence seizures often occur at times when the child is unstimulated, bored or tired. It’s rarer for them to happen whilst the child is active and receiving stimulus.

How CAE is diagnosed

Hyperventilation is a common method for diagnosing CAE. A doctor may ask a child to breathe heavily for 3 to 4 minutes whilst counting out loud. They may also instruct the child to close their eyes. Should the hyperventilation cause an absence seizure the child will stop breathing heavily and open their eyes.

An electroencephalogram (EEG) or magnetic resonance imaging (MRI) scan will likely be used to confirm the diagnosis of CAE. These may also be used to ascertain the effectiveness of the chosen treatment.

Treatment for CAE

CAE is known to respond well to treatment, antiepileptic drugs (AEDs) prescribed for this epilepsy syndrome include:

  • Sodium valproate
  • Ethosuximide
  • Lamotrigine

Less commonly:

  • Topiramate
  • Zonisamide

It’s possible that a mixture of two of the above AEDs may be prescribed to manage CAE. Children with CAE may also benefit from a ketogenic diet, a specialised diet that can help to manage various forms of epilepsy.

Prognosis

Approximately 70% of children who are diagnosed with CAE will be able to control their seizures through the use of one or two AEDs. The majority of children will also become seizure free as they reach puberty, only 10% will develop other seizure types as they reach adolescence.

Children with CAE rarely have any developmental or learning issues as they grow up, although if seizures remain uncontrolled it may disrupt learning.

National Epilepsy Training can help

For more information and advice on Childhood Absence Epilepsy, please don’t hesitate to contact us. Call us on 01706 373075 or email admin@nationalepilepsytraining.co.uk.