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Health condition

Petit mal seizures, brief lapses of awareness that are easy to miss.

A child who stares blankly for a few seconds, many times a day, may not be daydreaming. Absence seizures are common in school-age children, straightforward to diagnose with an EEG and usually respond well to treatment.

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Why trust this guide

  • 01

    Editorial team

    Written by our editorial team from the UK sources listed on each page.

  • 02

    Sourced from guidance

    Checked against NICE NG217, MHRA valproate advice and peer-reviewed sources you can see at the end.

  • 03

    Current for 2026

    Reflects modern UK practice, including first-line ethosuximide and the valproate Pregnancy Prevention Programme.

Key facts

Absence seizures at a glance.

The essentials, in plain English - what a spell looks like, how it is confirmed and how it is treated in the UK today.

  • What it is

    A brief lapse of awareness, usually 5 to 15 seconds, with a blank stare. "Petit mal" is the older name for what clinicians now call an absence seizure.

  • Who gets it

    Mostly children aged 4 to 10 with childhood absence epilepsy. A later-onset form, juvenile absence epilepsy, can begin in the early teens.

  • How often

    Can happen dozens of times a day. Because each one is so short, they are often mistaken for daydreaming or poor attention.

  • No recovery time

    The child snaps back to what they were doing with no post-ictal confusion, drowsiness or memory of the gap.

  • Key test

    An EEG showing 3 Hz generalised spike-and-wave discharges, often provoked by three minutes of deliberate over-breathing.

  • Outlook

    Most children with childhood absence epilepsy respond well to treatment and outgrow the seizures during adolescence.

Why this guide matters

Small seizures, real consequences.

Absence seizures are easy to overlook and easy to treat. The three points below shape everything else on this page.

  • They are often missed for months

    A few seconds of staring looks like daydreaming, so children are frequently labelled inattentive before anyone thinks of epilepsy.

  • The right medicine matters

    Ethosuximide works well for absences alone, while some common anti-seizure medicines can make them worse. The correct diagnosis steers the choice.

  • The outlook is usually good

    Most children with childhood absence epilepsy do very well, provided learning, safety and follow-up are looked after along the way.

How the diagnosis is made

From a staring spell to a confirmed EEG.

The steps a UK GP and paediatric neurologist will normally follow, in order - so you know what to expect and why.

  1. 01

    Recognising

    Witness description

    A parent or teacher describes the staring spells - length, frequency, eyelid flutter, lip-smacking. A phone video is enormously helpful.

  2. 02

    Recognising

    Examination and provocation

    Growth, development and neurology are checked. Three minutes of over-breathing often triggers a spell in clinic, which confirms the pattern.

  3. 03

    Recognising

    Rule out the mimics

    Daydreaming, inattention, hearing problems, focal seizures and faints can look similar and are considered before a diagnosis is made.

  4. 04

    Confirming

    Paediatric neurology referral

    NICE NG217 advises that children with a suspected seizure are seen by a specialist within two weeks.

  5. 05

    Confirming

    EEG

    The key test. Typical absence seizures show 3 Hz generalised spike-and-wave. A sleep-deprived recording may be added if the first is normal.

  6. 06

    Planning

    MRI if the picture is atypical

    Not routine when the syndrome is clear. Reserved for atypical features, focal findings, very early onset or poor response to treatment.

  7. 07

    Planning

    Classify and plan

    The syndrome, seizure types and risk of other seizure types shape the medicine choice, school plan and safety advice.

Typical timeline: a specialist visit within two weeks and an EEG shortly after.

Symptoms

What an absence seizure looks like.

Short, sudden and silent. Here is what parents and teachers usually notice - and the sign that means it is time for a fresh review.

  • Blank stare

    The hallmark - the child stops mid-sentence or mid-task, eyes fixed, and does not respond to their name.

  • Very brief

    Typically 5 to 15 seconds, starting and stopping abruptly, with no warning beforehand.

  • Eyelid flutter

    Rapid blinking or upward eye rolling during the spell, sometimes at around three beats a second.

  • Automatisms

    Lip-smacking, chewing, fumbling fingers or a slight head nod in some longer episodes.

  • Instant recovery

    Straight back to normal with no confusion or sleepiness - and often unaware anything happened.

  • Many times a day

    Clusters of spells across the day are common, and they are more likely when tired or unwell.

  • Patchy school performance

    Missed instructions and gaps in work that look like inattention - often the reason a teacher raises it first.

  • Red flag - other seizure types

    Any jerking, stiffening or collapse alongside the staring needs prompt specialist review.

Treatment

How absence seizures are managed in the UK.

Following NICE NG217: ethosuximide first for absences alone, valproate or lamotrigine as alternatives - alongside school support and sensible safety advice.

  • Watchful diagnosis first

    Treatment starts once the diagnosis is secure. A specialist confirms the syndrome so the right medicine is chosen from the outset.

  • Ethosuximide

    First-line for absence seizures when they are the only seizure type. Effective and well tolerated, though nausea, drowsiness and headache can occur.

  • Sodium valproate

    An alternative, and preferred where other seizure types are a risk. Avoid in girls and women who could become pregnant unless other options fail and the Pregnancy Prevention Programme is in place.

  • Lamotrigine

    Considered if ethosuximide and valproate are unsuitable or ineffective. Started slowly to reduce the risk of rash.

  • Medicines to avoid

    Carbamazepine, oxcarbazepine, phenytoin, gabapentin, pregabalin and vigabatrin can make absence seizures worse and are not offered.

  • School liaison

    An individual healthcare plan, staff who know what a spell looks like, and a quiet note-catching system for anything missed in class.

  • Safety advice

    Supervised swimming and showers rather than baths, care around water, heights and cycling on roads while spells are not yet controlled.

  • Review and withdrawal

    Regular specialist follow-up. After a long seizure-free period, medicines can often be withdrawn under specialist guidance.

What this guide is based on

The sources behind every claim on this page.

UK national guidance and specialist society standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP or paediatric neurologist knows your child and their history and can tell you which parts apply. If in doubt, get seen.

  • NICE. Epilepsies in children, young people and adults (NG217).

  • MHRA. Valproate use in girls and women: Pregnancy Prevention Programme requirements.

  • International League Against Epilepsy (ILAE). Classification of seizures and epilepsy syndromes.

  • Epilepsy Action and Young Epilepsy. Patient guidance on absence seizures and school support.

Red flags

When to seek urgent help.

Typical absences are not dangerous in themselves. These are the situations that need prompt medical attention.

  • A convulsion lasting over 5 minutes

    Stiffening or jerking that does not stop within five minutes is a medical emergency - call 999.

  • Prolonged confusion or staring

    Spells lasting many minutes or hours with a dazed child may be absence status and need urgent hospital assessment.

  • New jerking or stiffening

    The appearance of generalised tonic-clonic seizures means the treatment plan needs prompt specialist review.

  • Injury during a seizure

    Falls, head injury, or being unsafe near water or roads need urgent advice and a safety plan.

  • Developmental slowing or regression

    Loss of skills, worsening learning or behaviour points away from simple childhood absence epilepsy and needs investigation.

  • Seizures getting worse

    More frequent spells or new features on treatment should be reported early. Some medicines can make absences worse.

  • Rash on lamotrigine

    Any new rash, fever or mouth sores in the first weeks needs same-day medical advice.

  • Pregnancy on valproate

    Valproate carries serious risks in pregnancy. Do not stop it abruptly - seek urgent specialist advice.

  • Low mood, anxiety or behaviour change

    Epilepsy and some anti-seizure medicines affect mood - tell the specialist team early.

Living with it

A manageable condition, with a good outlook.

Four things that make the biggest difference day to day - an informed school, sensible safety habits, steady routines and regular reviews.

A quiet reminder

A diary of spells is worth its weight in gold.

Noting the date, time and length of spells - and a short phone video - helps the team judge whether treatment is working.

  1. 01 School

    Make sure teachers know

    Share what a spell looks like and agree a plan. Repeating anything missed during a lapse protects learning and confidence.

  2. 02 Safety

    Supervise water and heights

    Showers over baths, an adult within arm’s reach when swimming, and a helmet and care for cycling until seizures are controlled.

  3. 03 Routine

    Protect sleep and medicines

    Regular sleep, doses at the same time each day and a written record of spells help the team judge treatment.

  4. 04 Outlook

    Most children grow out of it

    Childhood absence epilepsy usually remits in adolescence. Keep attending reviews so withdrawal and later plans are made safely.

Frequently asked

Everything we get asked about absence seizures.

Quick answers on diagnosis, the EEG, medicines and the long-term outlook.

  • What is a petit mal seizure?

    Petit mal is the older term for an absence seizure - a brief lapse of awareness lasting around 5 to 15 seconds, with a blank stare and sometimes eyelid flutter. The child stops, then carries on as if nothing happened.

  • How is it different from daydreaming?

    A daydreaming child can be brought back by touch or a call of their name. During an absence seizure they cannot be roused, the spell starts and stops abruptly and it can happen mid-conversation or mid-meal. An EEG settles the question.

  • What does the EEG show?

    Typical absence seizures produce 3 Hz generalised spike-and-wave discharges, often triggered by three minutes of over-breathing. It is the key diagnostic test, and a normal recording between spells does not always rule the condition out.

  • Which medicine is used first?

    NICE NG217 recommends ethosuximide first for absence seizures when they are the only seizure type. Sodium valproate is an alternative, and lamotrigine is an option if the others are unsuitable or do not work.

  • Is sodium valproate safe for girls?

    Valproate carries a high risk of harm to an unborn baby, so it should not be used in girls and women who could become pregnant unless other treatments have failed and the Pregnancy Prevention Programme is followed. Ethosuximide is usually chosen first.

  • Will my child grow out of it?

    Most children with childhood absence epilepsy stop having seizures in adolescence, and medicines can often be withdrawn under specialist guidance. A minority go on to develop other seizure types, which is why follow-up matters.

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