A seizure is defined as an occurrence of transient signs and/or symptoms due to abnormal,  excessive or synchronous neuronal activity in the brain. It may be defined as epilepsy only  after the individual has had two or more such unprovoked seizures.  

Absence Epilepsy (AE) is an idiopathic epilepsy that involves brief, sudden lapses of  consciousness generally for 5-15 seconds, mainly in children between 4-10 years of age. It  encompasses an otherwise structurally normal brain on neuroimaging with epilepsy as the  only neurological problem.  

Absence seizures in children and teenagers were generally considered relatively benign  because of their non-convulsive nature and the large incidence of remittance in early  adulthood. However recent studies show that 30% of children with absence seizures are  pharmaco-resistant and 60% are affected by severe neuropsychiatric comorbid conditions,  including impairments in attention, cognition, memory and mood. Attention deficits can be  detected even before the epilepsy diagnosis, and they may persist even when seizures are  pharmacologically controlled. Ethosuximide, sodium valproate and lamotrigine are the first  line drugs and recent studies indicate that the attention deficits may be aggravated by valproic  acid monotherapy. Thus there is a need to emphasize on the importance of a detailed clinical  history and examination for the early detection of these non-motor seizures or a very mild  motor phenomena which may otherwise go unnoticed or be considered non epileptic.  

KEY WORDS: Absence seizures/ Epilepsy, Homoeopathy, pediatrics  


Absence seizures affect around 6-8 per 100,000 in children younger than 15 years. AE  constitutes 10% of all patients with pediatric epilepsy.  

The first description of absence seizures was made by Poupart in 1705 and Tissot in 1770. In  1824, Calmeil introduced the term, absences, and in 1838, Esquirol for the first time used the  term petit mal. Delasiauve introduced the concept of idiopathic epilepsy. The term  pyknolepsy belongs to the 20th century. It was definitely recognized as an epileptic entity  only in 1945, based on EEG recordings.  

AE is more common in females than in males. AE may be typical, atypical, myoclonic or  eyelid myoclonias.  

A typical AE usually presents with multiple daily blank spells with sudden cessation of  activity for a few seconds (5-15s) associated with fluttering or uprolling of eyes or staring 

and automatisms, only noticeable by others but the patient himself being unaware of it  promptly resumes his activity without a postictal state. Hyperventilation for 3-5 minutes can  demonstrate suspected typical AE in a child in the OLD settings. The classic EEG finding is  of 3 Hz spike-and-slow-wave discharges.  

Eyelid myoclonia (Jeavons syndrome i.e. eye closure) or myoclonic absences (i.e. periorbital,  perioral or limb myoclonic jerks) along with typical AE are difficult to treat.  

Atypical AE is associated with myoclonia and hypotonia/atonia of the head and the body and  is precipitated by drowsiness. These episodes have a slow onset and offset. They are difficult  to treat. They display 1-2 Hz spike-and-slow-wave discharges.  

Juvenile AEs are similar to typical AEs but they begin later (7-17 yrs) associated with Juvenile  myoclonic epilepsy and generalized clonic tonic seizures. ECG shows 4-6 Hz spike-and slow-wave discharges.  


This electro-clinical syndrome may also be described as an age related non motor genetically  generalized epilepsy (GGE) whereby the pathophysiology of AE points towards a genetically  predetermined lowered threshold for seizures. Early onset AE (<4 yr of age) or drug  resistance may be related to an abnormal glucose transporter defect with low CSF glucose  levels.  

Blood oxygenation level-dependent (BOLD) functional MRI studies help in identifying the  key regions involved in human absence seizures. The lack of generalization at the start of an  absence seizure and localized changes in precuneus, posterior cingulate cortex, lateral parietal  cortex and/ or frontal cortex referred to as the cortical initiation network (CIN) are observed  before other brain areas become involved in the paroxysm. Different individuals may display  diverse CINS depending on their peculiar genotypes.  

The persistent ictal and interictal altered cortical sensorimotor network in people with  absence seizure is a major finding to correlate these seizures with their neuropsychiatric  comorbidities.  

Changes in the firing of cortical, thalamic and basal ganglia neuronal populations just around  short wave diathermy (SWD) offset have been proposed as terminators of the seizure.  


Recurrent febrile seizures  

Febrile seizure plus syndrome  

Familial predisposition to epilepsy or neurological illnesses  

Genetic disorders associated with epilepsy  

Familial discords or psychological problems faced at school by the child contribute to  stress. 

Post traumatic brain injury  

Cerebrovascular infections  

Neuronal damage and nerve conduction defect.  


Photic stimulation i.e. strobe lights, flipping through TV channels, viewing video games,  prolonged screen time on any digital media  


sleep deprivation  

Alcohol withdrawal  

Recreational drug misuse  

Physical and mental exhaustion  

loud noises, music, reading, hot baths, cold weather.  


AE is a typical example of a “one sided disease” as described by our master Dr Samuel  Hahnemann in aphorism 173 and they belong chiefly to the class of chronic diseases. The  treatment of AE can follow Constitutional, Anti Miasmatic or pathological approaches  depending on the individuality of each case.  

Inputs from Materia medica:  

Artemisia vulgaris: epileptic diseases, convulsive diseases of childhood and girls at puberty.  petit mal epilepsy without aura after fright, violent emotions, masturbation, several  convulsions close together.  

Stramonium: convulsions with consciousness renewed by sight of bright light, of mirror, of  water. pupils dilate when the child is reprimanded  

Nux vomica: Convulsions with consciousness agg anger, emotions, touch, light, moving  

Bufo rana: Epileptic syndromes in feeble minded children. Epilepsy at the time of menses,  sexual excitement, at the change of moon.  

Inputs from Repertory:  

Pocket Manual of Homoeopathic Materia Medica by William Boericke  Nervous system, Brain, Epilepsy – Petit mal  

The Guiding Symptoms Of Our Materia Medica by C Hering: 

 NERVES, Convulsions, Epileptiform (petit mal)  

Synthesis Repertory  

Generals-Petit Mal Mind Absences cross referred to: Mind- Unconsciousness frequent spells  of unconsciousness  

Other rubrics from ‘Generals’ chapter for AE:  

Under the Rubric: ‘Convulsions’  


Children in  

Brain complaints of- accompanied by  

Exertion after  

Mental exertion after  

contradiction from  

scolded after being  

bright light from  


sleep loss of from  

Cold and Cold agg becoming  

Various repertories have elaborated absence seizures using different rubrics. However when  referred back to many materia medicas, it is found that these rubrics may not always  correspond to the symptoms of ‘absence’ type of seizures.  

Dr JH Clarke quotes in “The Prescriber’ that epilepsy will often be removed by medicines  homeopathic to the general conditions when medicines chosen according to the  characteristics of the epilepsy alone would have no influence.  

This is accurate in the case of absence seizures. Every homeopath must therefore strive to  investigate and understand the dynamics that take place in the lives of patients i.e. the most  significant points in the whole history of the chronic disease to discover the fundamental  cause to prescribe a well suited remedy that brings about a holistic cure.  


Creating awareness regarding the recognition and the seriousness of this kind of epilepsy by  the parents or bystanders is key for it’s early detection and treatment.  

There is a need to explore the scope of lesser known and partially proved homeopathic  medicines particularly for “absences” in greater detail. Evidence based studies related to the  treatment of children presenting with co-morbidities of AE must be performed. Homoeopathy 

has proven to be effective in the treatment and reduction of recurrence of absence seizures  however further research studies are needed to show conclusive results.  


1. Brigo F, Igwe SC. Ethosuximide, sodium valproate or lamotrigine for absence  seizures in children and adolescents. Cochrane Database Syst Rev. 2017 Feb  14;2(2):CD003032.  

2. Crunelli V et. all Clinical and experimental insight into pathophysiology, comorbidity  and therapy of absence seizures. Brain. 2020 Aug 1;143(8):2341-2368. doi:  10.1093/brain/awaa072. PMID: 32437558; PMCID: PMC7447525.  

3. Tangwiriyasakul C et. al Dynamic brain network states in human generalized spike wave discharges. Brain. 2018 Oct 1;141(10):2981-2994. doi: 10.1093/brain/awy223.  PMID: 30169608; PMCID: PMC6158757.  

4. Nelson’s Textbook of Paediatrics 21st Edition  

5. Piyush Gupta PG Textbook of Paediatrics 3rd Edition  

6. The Guiding Symptoms Of Our Materia Medica by Dr C. Hering  

7. Pocket manual of Homoeopathic Materia Medica by Dr William Boreicke  8. Synthesis Repertory  

9. The Prescriber by Dr JH Clarke  

About the author

Dr Krithi R

Dr Krithi R - Paediatrics MD Part 1 scholar, Government Homoeopathic Medical College Bangalore 560079, under the guidance of Dr V Guruprasad, HOD, Department of Paediatrics