Children, who are often seen as lost in thought, staring blankly into space, stopping mid-sentence, or not reacting when spoken to, may not always be distracted or inattentive. Certain types of seizures in childhood can appear as brief, multiple episodes, which makes them difficult to identify because they resemble inattention and behavioural problems.
Absence seizure, which is one of the common seizure types seen in children, causes very brief periods of unawareness and unresponsiveness (black out). These episodes last only a few seconds but can happen multiple times throughout the day. During this episode, the child may stop their current activity, stare into space, ignore anyone who approaches them, and repeatedly blink one or both eyes. Once the episode ends, the child resumes normal activities and is typically unaware that anything unusual occurred. The short duration of these episodes, with their non-threatening appearance, leads people to misinterpret them as basic daydreaming, which makes it essential for caregivers to observe and monitor the child. In India, recent studies have shown that about 0.8% of children and adolescents have epilepsy. As this contributes to a significant burden, it emphasises the need for early detection of the symptoms of seizures to provide timely treatment.
Focal seizures, another type of seizure, often present with less obvious symptoms. The condition originates from brain regions which produce brief episodes of confusion and repetitive behaviour that includes lip smacking, hand rubbing, and sudden pauses while speaking. Children may display their emotional distress through subtle signs while they temporarily pull away from social situations. The brief episodes, which last for a short time, often get mistaken for symptoms of tiredness, lack of interest, or distraction, which creates challenges for early diagnosis and can quietly disrupt the child’s daily routine.
Undetected seizures that occur in children lead to detrimental effects on their ability to learn and their self-esteem. Constant interruptions in attention make it very difficult to focus on lessons, retain information, and engage in classroom activities. Over time, these challenges can lead the child to experience academic difficulties, together with emotional distress, because their behaviour will create repeated misunderstandings, which will damage their self-esteem. Usually, parents and teachers are the first to spot such behaviour changes. Recurrent staring episodes, unresponsiveness to questions, pauses during activities, or any unusual movements are all signs that should not be ignored. Such behaviour regularly being observed should be a reason to see a doctor. Only a medical professional can properly diagnose and help prevent more serious emotional or academic consequences. Intervention at the earliest stage makes it possible to give the child the necessary support and prevent learning and social difficulties.
An electroencephalogram or EEG is very helpful for the diagnosis of seizures. This test measures the electrical activity of the brain and can detect unusual changes, and therefore doctors can find out the type of seizure and implement the best treatment plan.
Drug therapies nowadays can very effectively control seizures and reduce their impact on school, daily routine, and overall well-being. Besides medical treatment, supportive measures like counselling, parent and teacher education, and well-organised awareness programmes can significantly empower a child’s self-confidence and performance. Being able to identify subtle seizure symptoms enables caregivers and teachers to give immediate help and ensures that the child is in a comforting setting.
Identifying that repetitive ‘daydreaming’ might be caused by a neurological disorder can have a big impact on a child’s life. A diagnosis in time, correct treatment, and staying informed can stop the occurrence of learning problems, enhance emotional health, and promote social skills, thus enabling children to enjoy the experience of growth without any obstacles. Through vigilant observation, prompt intervention, and well-planned assistance, children with subtle seizures can mature, acquire knowledge, and completely engage with daily life and live upto their maximum potential.
By Dr Chakkera Priyanka, consultant, Neurology, Kauvery Hospital Vadapalani.