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Epilepsy

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Epilepsy

Definition:

Epilepsy is a brain disorder involving recurrent seizures.

Alternative Names:
Seizure disorder

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Causes, incidence, and risk factors:

Epilepsy is a disorder involving repeated seizures of any type. Seizures ("fits") are episodes of disturbed brain function that cause changes in attention and/or behavior. They are caused by abnormal electrical excitation in the brain.

Sometimes, seizures are related to a temporary condition, such as exposure to drugs, withdrawal from certain drugs, or abnormal levels of sodium or glucose in the blood. In such cases, repeated seizures may not recur once the underlying problem is corrected.

In other cases, injury to the brain (e.g., stroke or head injury) causes brain tissue to be abnormally excitable. In some people, an inherited abnormality affects nerve cells in the brain, which leads to seizures. In some cases, no cause can be identified.

Some of the more common causes of seizures include:

• Idiopathic (no identifiable cause)
  • usually begin between age 5 and 20
  • can occur at any age
  • no other neurologic abnormalities present
  • often a family history of epilepsy or seizures
• Developmental or genetic conditions present at birth, or injuries near birth -- in this case, the seizures usually begin in infancy or early childhood
• Metabolic abnormalities
  • may affect people of any age
  • diabetes complications
  • electrolyte imbalances
  • kidney failure, uremia (toxic accumulation of wastes)
  • nutritional deficiencies
  • phenylketonuria (PKU) -- can cause seizures in infants
  • other metabolic diseases, such as inborn error of metabolism
  • use of cocaine, amphetamines, alcohol, or certain other recreational drugs
  • withdrawal from alcohol
  • withdrawal from drugs, particularly barbiturates and benzodiazepines
• Brain injury
  • may affect any age, but most common in young adults
  • most likely to occur if the brain membranes are damaged
  • seizures usually begin within 2 years after the injury
  • early seizures (within 2 weeks of injury) -- do not necessarily indicate that chronic (ongoing) seizures (epilepsy) will develop
• Tumors and brain lesions that occupy space (such as hematomas)
  • may affect any age, more common after age 30
  • partial (focal) seizures most common initially
  • may progress to generalized tonic-clonic seizures
• Disorders affecting the blood vessels (such as stroke and TIA)
  • most common cause of seizures after age 60
• Degenerative disorders (senile dementia Alzheimer type, or similar organic brain syndromes)
  • mostly affect older people
• Infections
  • may affect people of all ages
  • may be a reversible cause of seizures
  • brain infections like meningitis and encephalitis can produce seizures
  • brain abscess
  • acute severe infections of any part of the body
  • chronic infections (such as neurosyphilis)
  • complications of AIDS or other immune disorders