Editing Absence seizure (section)

==Signs and symptoms==
The clinical manifestations of absence seizures vary significantly among patients.<ref name = "electroencephalographic1981" /><ref name = "ReferenceA" /><ref name = "panayiotopoulos1" /> Impairment of consciousness is the essential symptom, and may be the only clinical symptom, but this can be combined with other manifestations.  The hallmark of the absence seizures is abrupt and sudden-onset impairment of consciousness, interruption of ongoing activities, a blank stare, possibly a brief upward rotation of the eyes. If the patient is speaking, speech is slowed or interrupted; if walking, they stand transfixed; if eating, the food will stop on its way to the mouth. Usually, the patient will be unresponsive when addressed. In some cases, attacks are aborted when the patient is called.  The attack lasts from a few seconds to half a minute and evaporates as rapidly as it commenced. Absence seizures generally are not followed by a period of disorientation or lethargy (postictal state), in contrast to the majority of seizure disorders.<ref name = EpilepsyFoundation /> If the patient has jerking gestures during the seizure this might be the indication of another type of seizure occurring onward with the absence seizure.<ref name="hopkinsmedicine.org">{{cite web |title=Absence Seizures |url=https://www.hopkinsmedicine.org/health/conditions-and-diseases/epilepsy/absence-seizures |website=Johns Hopkins Medicine }}</ref>

# Absence with impairment of consciousness only as per the above description.<ref name="EpilepsyFoundation" />
# Absence with mild [[Clonus|clonic]] components.  Here the onset of the attack is indistinguishable from the above, but clonic components may occur in the eyelids, at the corner of the mouth, or in other muscle groups which may vary in severity from almost imperceptible movements to generalised myoclonic jerks. Objects held in the hand may be dropped.{{Citation needed | date = October 2014}}
# Absence with [[Atony|atonic]] components.  Here there may be a diminution in tone of muscles subserving posture as well as in the limbs leading to dropping of the head, occasional slumping of the trunk, dropping of the arms, and relaxation of the grip.  Rarely tone is sufficiently diminished to cause this person to fall.{{Citation needed | date = October 2014}}
# Absence with tonic components.  Here during the attack tonic muscular contraction may occur, leading to increase in muscle tone which may affect the [[extensor muscle]]s or the [[flexor muscle]]s symmetrically or asymmetrically.  If the patient is standing, the head may be drawn backward and the trunk may arch. This may lead to retropulsion, which may cause eyelids to twitch rapidly; eyes may jerk upwards or the patients head may rock back and forth slowly, as if nodding.<ref>{{cite journal | pmc = 4491640 | pmid=26155465 | doi=10.1016/j.ebcr.2015.06.006 | volume=4 | title=Focal frontal epileptiform discharges in a patient with eyelid myoclonia and absence seizures | year=2015 | journal=Epilepsy Behav Case Rep | pages=35–7 |vauthors=Takahashi S, Yamamoto S, Tanaka R, Okayama A, Araki A, Azuma H }}</ref><ref>{{cite book|author=John S. Duncan|title=Eyelid Myoclonia with Absences|url=https://books.google.com/books?id=UMpB-tOt6zgC&pg=PA52|year=1996|publisher=John Libbey Eurotext|isbn=978-0-86196-550-2|pages=52–}}</ref><ref>{{cite book|author=Antonio V. Delgado-Escueta|title=Myoclonic Epilepsies|url=https://books.google.com/books?id=J-S_GiypB9IC&pg=PA104|year=2005|publisher=Lippincott Williams & Wilkins|isbn=978-0-7817-5248-0|pages=104–}}</ref> The head may tonically draw to one or another side.{{Citation needed | date = October 2014}}
# Absence with [[Automatism (medicine)|automatisms]].  Purposeful or quasi-purposeful movements occurring in the absence of awareness during an absence attack are frequent and may range from lip licking and swallowing to clothes fumbling or aimless walking.  If spoken to, the patient may grunt, and when touched or tickled may rub the site.  Automatisms are quite elaborate and may consist of combinations of the above described movements or may be so simple as to be missed by casual observation.<ref name="automatismstudy">{{cite journal |last1=Myers |first1=Kenneth |title=Myoclonic absence seizures with complex gestural automatisms |journal=European Journal of Paediatric Neurology |date=May 2018 |volume=22 |issue=3 |pages=532–535 |doi=10.1016/j.ejpn.2017.12.003 |pmid=29325826 }}</ref>
# Absence with [[Autonomic nervous system|autonomic]] components.  These may be [[pallor]], and less frequently flushing, sweating, dilation of pupils and incontinence of urine.{{Citation needed | date = October 2014}}
Mixed forms of absence frequently occur.
These seizures can happen a few times a day or in some cases, hundreds of times a day, to the point that the person cannot concentrate in school or in other situations requiring sustained, concentrated attention.<ref name = EpilepsyFoundation />