A 4 year old male has blank staring periods that last 15 seconds. He is fully conscious when the episodes begin and after they end suddenly. You should suspect:

• A. Absence seizures
• B. Jacksonian seizures
• C. Focal motor seizures
• D. Hypotonic seizures

Answer: (A)

Brief episodes where a child stares and seems to lose awareness for a few seconds are hallmark of absence seizures. In these events consciousness is briefly impaired with a sudden onset and offset, and the child is typically fully aware before and after the spell, sometimes with subtle automatisms like eye blinking or lip smacking. They usually last only a few seconds, often around 15, and there is no postictal confusion. EEG often shows rhythmic 3 Hz spike-and-wave discharges. This pattern fits the vignette of a 4-year-old with blank staring spells lasting about 15 seconds and preserved consciousness at the start and end. Other seizure types would show focal motor activity (as in Jacksonian or focal motor seizures) or a sudden loss of muscle tone with collapse (hypotonic seizures), not a pure blank stare.