NIH - Medical Encyclopedia Epilepsy

"Some seizures are idiopathic, which means the cause can not be identified. Such seizures usually being between age 5 and 20, but can occur at any age. People with this condition have no other neurological problems, but often have a family history of seizures or epilepsy. Disorders affecting the blood vessels, such as stroke and TIA, are the most common cause of seizures after age 60. Degenerative disorders such as senile dementia Alzheimer type can also lead to seizures.

Some of the more common causes of seizures include:

Developmental problems, genetic conditions present at birth, or injuries near birth (seizures usually begin in infancy or early childhood)

Metabolic abnormalities may affect people of any age and may be a result of:

o Diabetes complications o Electrolyte imbalances o Kidney failure, uremia (toxic accumulation of wastes) o Nutritional deficiencies o Phenylketonuria (PKU) -- can cause seizures in infants o Other metabolic diseases, such as inborn error of metabolism o Use of cocaine, amphetamines, alcohol, or certain other recreational drugs o Withdrawal from alcohol o Withdrawal from drugs, particularly barbiturates and benzodiazepines

Brain injury o Most common in young adults o Seizures usually begin within 2 years after the injury o Early seizures (within 2 weeks of injury) do not necessarily mean that chronic (ongoing) seizures (epilepsy) will develop

Tumors and brain lesions (such as hematomas) o May affect any age but are more common after age 30 o Partial (focal) seizures most common to start with o May lead to generalized tonic-clonic seizures

Infections o May affect people of all ages o May be a reversible cause of seizures o Brain infections like meningitis and encephalitis can produce seizures o Brain abscess o Acute severe infections of any part of the body o Chronic infections (such as neurosyphilis) o Complications of AIDS or other immune disorders.

Seizure disorders affect about 0.5% of the population. Approximately 1.5-5.0% of the population may have a seizure in their lifetime. Epilepsy can affect people of any age."

Highlighted Article

Refractory Epilepsy: Clinical Overview (Epilepsia 2007)

"The incidence of refractory epilepsy remains high despite the influx of many new antiepileptic drugs (AEDs) over the past 10 years. Epidemiological data indicate that 20–40% of the patients with newly diagnosed epilepsy will become refractory to treatment. Factors that may be used to predict whether or not a patient will respond favorably to AED therapy include the type of epilepsy, underlying syndrome, etiology, and the patient's history of seizure frequency, density, and clustering. Environmental factors, such as trauma and prior drug exposure, and genetic factors that predetermine the rate of absorption, metabolism, and uptake of a drug by target tissue may also uniquely impact an individual and influence their response to AED therapy."

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NIH - Medical Encyclopedia Seizures

"What to expect at your health care provider's office: The doctor will perform a physical examination and ask questions to help understand the cause of the seizures, such as: • Did it occur or start on one side of the body? • Was there movement of the muscles and if so, what was the pattern? • Are there any risk factors (such as recent head injury)? • Was consciousness maintained during the seizure? • How long did the seizure last? • What are the frequency of the seizures? • Was there any warning (aura) of the seizures? • Were there any other symptoms present (visual changes, abnormal smells)? The following diagnostic tests may be performed: • CT scan of the head or MRI of the head • EEG • Lumbar puncture • Blood tests"