Myth: If someone stares blankly, they must be having an absence seizure.
Fact: Staring can have many causes. Some staring episodes are absence seizures, some are focal seizures, and others are non-epileptic.
Why staring is difficult to interpret
A brief pause can occur with daydreaming, inattention, fatigue, behavioural arrest, medication effects and several neurological or developmental conditions. What matters is the pattern of the event rather than the appearance of staring alone.
Absence seizures have a specific pattern
Typical absence seizures are usually brief and begin and end abruptly. They are most often associated with generalized epilepsies and have characteristic EEG findings. But not every episode of reduced responsiveness or staring has that pattern.
Focal seizures can also look like staring
Some focal seizures can produce behavioural arrest, reduced responsiveness or a fixed stare. They may last longer, include automatisms or be followed by confusion, but there is overlap and appearance alone is not enough for diagnosis.
What research has found
In a study of children referred for newly presenting staring spells, roughly half were ultimately diagnosed with epileptic seizures and half with non-epileptic staring. Among the epileptic group, both absence and focal seizures were found. History and EEG together were important in separating the groups.
The useful question is not just ‘was there staring?’
Clinicians look at duration, responsiveness, automatisms, triggers, recovery, frequency, age, developmental context and EEG findings. A video of a typical episode can sometimes help the clinical assessment.
Sources
Staring Spells: How to Distinguish Epileptic Seizures from Nonepileptic Staring
ILAE — Updated classification of epileptic seizures, 2025