Differentiate ADHD and Childhood Absence Epilepsy (CAE), Confidently.
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What is CAE and Absence Seizures?
- Childhood Absence Epilepsy (CAE) is the most common epilepsy in children, marked by recurrent absence seizures.
- Absence seizures are brief, non-convulsive episodes characterized by sudden interruptions in awareness, typically presenting as a blank stare, unresponsiveness, or behavioral arrest .
- Absence Seizures typically last 5-15 seconds and can occur 10-30 times a day often mistaken for daydreaming or inattentiveness.
- CAE is estimated to affect 1 in 1,000 children, though true prevalence may be higher due to frequent under recognition of absence seizures
- Typical onset is between ages 4-12 year olds, with a higher prevalence in girls.
Primary Care Challenge: Ruling out Absence Seizures
The American Academy of Pediatrics Guidelines on ADHD recommends to rule out alternative causes to inattention (such as absence seizures) before making a diagnosis of ADHD and to identify co-occuring conditions (such as absence seizures) that could impact ADHD treatment plans.
Clinical history and subjective screeners may not be enough to tell one condition from another. For example, 90% of parents of children with CAE report staring behaviors, as do 80% of parents of children with Inattentive ADHD.
Timing of conditions when they co-occur can make treatment planning a challenge. Up to 50% of children with CAE also have ADHD, with attention deficits presenting before the diagnosis of CAE.