Petit mal seizure

Alternative Names

Symptoms

TYPICAL

• Muscle activity changes
  • No movement
  • Hand fumbling
  • Fluttering eyelids
  • Lip smacking
  • Chewing
• 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

• Atonic seizure
  • No muscle movement
  • Slumping, loss of posture
  • Loss of muscle tone
  • Falling down
• Consciousness changes
  • 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

Exams and Tests

The physical examination is usually normal, although some neurologic abnormalities may be present in some patients.

Transmission of information from nerve cell to nerve cell occurs by an electrochemical process that can be detected as electrical activity by an electroencephalograph (EEG). A single or multiple EEG exams may be necessary to show changes typical of petit mal seizures. Occasionally, a patient may need to have EEG monitoring from 1 to several days to detect these EEG changes.

Various laboratory tests, a head CT scan, or a head MRI may be used to rule out specific causes of the seizures.

References

Hirtz D, Ashwal S, Berg A, et al. Practice parameter: Evaluating a first nonfebrile seizure in children: Report of the Quality Standards Subcommittee of the American Academy of Neurology, the Child Neurology Society, and the American Epilepsy Society. Neurology. 2000;55;616-623.

Hirtz D, Berg A, Bettis D. Practice parameter: Treatment of the child with a first unprovoked seizure: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society.Neurology. 2003;60;166-175.

Goetz, CG. Textbook of Clinical Neurology. 2nd ed. St. Louis, Mo: WB Saunders; 2003.

Marx J. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, Mo: Mosby; 2002.