Epilepsy
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Causes of Seizures
Epileptic seizures can result from many different causes. Some common causes include:
- problems in brain development prior to birth from events such as infection, stroke, or cortical dysplasias
- problems during birth such as lack of oxygen
- postnatal infection, low blood glucose and/or calcium
- tumors
- traumatic brain injury (TBI)
- meningitis, encephalitis, brain abscesses
- cerebrovascular accidents CVA's; strokes)
- inherited diseases such as neurofibromatosis, tuberous sclerosis or phenyketonuria (PKU)
Seizures are often categorized as being symptomatic or idiopathic. Symptomatic seizures are the result of some type identifiable problem such as TBI, stroke, infection, etc. Idiopathic seizures (sometimes called primary or cryptogenic seizures) are the most common in childhood and occur as a result of an unknown genetic or physiological disposition. In these cases the cause cannot be identified. Oftentimes there is a family history of epilepsy. The majority of children with epilepsy have idiopathic seizures.
Events that may be mistaken for seizure activity.
Not everything that looks like a seizure is a seizure. There are many psychiatric and medical problems that can result in a sudden alteration in consciousness. These include:
- migraine headaches
- sleep disorders (eg sleep walking)
- staring episodes
- obsessive-compulsive disorder
- hypoglycemic episodes
- cardiac syncope
- "psychogenic seizures"
Nonepileptic "psychogenic seizures". These are episodic events wherein the individual has a sudden, dramatic alteration in behavior that looks like a seizure (e.g. side to side heading shaking, pelvic thrusting). but turns out to represent a psychological disorder. These events have been given other names including "pseudoseizures", "hysterical seizures", and "nonepileptic events. The incidence of individuals having nonepileptic seizures has been estimated to be between 200k and 400k in the US. Many individuals with nonepileptic seizures have a history of true epilepsy. Sixty-five to eighty percent are females (Gates, et al, 1991). Commonly reported predisposing factors include:
- having a friend with epilepsy
- sexual assualt/molestation by the middle teen years
- female gender
- onset between age 5 and 15
Some features that distinguish the person with true epilepsy from "nonepileptic psychogenic" seizures (Gates et.al. 1991):
| Feature |
Epilepsy |
Nonepileptic |
| Attack pattern |
similar |
variable |
| Apparent cause |
absent |
emotional distress |
| Age of onset |
early |
late |
| Frequency |
low |
high |
| Others present |
yes/no |
yes |
| Place |
anywhere |
indoors |