Duration of discharges is typically 3-25 seconds. Eye opening does not alter the discharges. However, discharges are state dependent. Their frequency increases with non-REM sleep, although the duration of the discharges is reduced. During REM sleep the frequency of discharges resembles that seen in wakefulness.
Generalized discharges are ictal in nature.
They may be so brief that no obvious clinical movements are seen, although typically, minor eyelid fluttering or subtle rhythmic contractions of the mouth are seen. Typically, a child with staring spells is misdiagnosed as having partial complex seizures and treated with carbamazepine. They are able to intermittently answer questions, although at times are confused. EEG is crucial in the diagnosis. It shows near-continuous generalized spike and wave discharges.