Q: My 11 years old daughter used to give a blank stare at times. We approached a neurologist who after doing the EEG, diagnosed it as petit mal and prescribed Valproate Chrono 300, which she is continuously taking for the last one year. So far she has shown good signs and since then there has been no recurrence of the symptom as we are closely monitoring her. What is petit mal? Is she on right treatment?

A:" Absence seizures" is the term which has replaced the old French term 'petit-mal". This epilepsy is classified as an idiopathic( likely genetic), generalised epilepsy that starts and affects both hemispheres of the brain and shows the following features: starts abruptly without an aura. lasts from a few seconds to half a minute ends abruptly frequent eye blinking, lip smacking, decrease in tone, and automatisms. The best description was given by Gowers, a great neurologist, in 1881: "patient stops for a moment whatever he or she is doing, very often turns pale, may drop what ever is in the hand. . . There may be a slight stoop forward, or a slight quivering of the eyelids. . . The attack usually lasts only a few seconds. The return of the consciousness may be sudden and the patient, after the momentary lapse, may be in just the same state as before the attack, may even continue a sentence or action which was commenced before it came on, and suspended during the occurrence." The remission rate for childhood absence epilepsy is good; 80% respond to medication. Complete remission rates vary widely, perhaps dependent on the length of follow-up. Early onset of absence seizures, quick response to therapy , and normal EEG background are good prognostic signs. Valproate and lamotrigine are the drugs of choice for treatment of Absence Epilepsy. A liver function test and CBC could be done after 2-3 months. Treatment should should continue for 2 years fit free period and the EEG should normalize.