Etiology

• Incidence of unprovoked seizures: 61 per 100,000 population

• Incidence of epilepsy: 79.1 per 100,000 population

• Prevalence of epilepsy: 8.5 per 1,000 population

Seizure triggers are stimuli that can precipitate seizures both in people with and without epilepsy.

• Excessive physical exertion

• Alcohol consumption

• Fever (febrile seizures)

• Sleep deprivation

• Flashing lights (e.g., strobe lights, video games)

• Music

• Hormonal changes (e.g., at different phases of the menstrual cycle, after menopause)

• Medication-related issues in patients with known epilepsy: e.g., poor adherence, recent changes in drug doses or formulation, new medication interactions

• TBI

• Stroke

• Anoxic encephalopathy

• Intracranial surgery

• Acute CNS infections (e.g., meningitis, encephalitis)

• Electrolyte imbalance (e.g., hypoglycemia, hypocalcemia)

• Acute metabolic disturbances (e.g., uremia)

• Alcohol withdrawal

• Recreational drug use

• Prescription drug toxicity

• Exacerbations of autoimmune disorders (e.g., SLE)

• Genetic

  • Genetic mutations affecting ion channels or transmitter receptors (e.g., mutations in KCNQ2 or SCN1A genes)

  • Chromosomal abnormalities (e.g., Angelman syndrome, Prader-Willi syndrome, Rett syndrome)

  • Genetic metabolic disorders (e.g., PKU, congenital disorders of glycosylation, lysosomal storage diseases, peroxisomal biogenesis disorders)

  • Mitochondrial diseases (e.g., MELAS)

• Structural: chronic cerebral lesion or abnormality

  • Perinatal injury, e.g., hypoxic-ischemic injury

  • Brain tumors and metastases [13]

  • Traumatic brain injury (TBI)

  • Hippocampal sclerosis

  • Tuberous sclerosis

  • Congenital cerebral or arteriovenous malformations

  • Microcephaly, megalocephaly, cortical dysgenesis

  • Cranial radiation therapy

• Metabolic

  • Inborn errors of metabolism (e.g., organic acidemias, phenylketonuria)

  • Porphyrias

• Immune: autoimmune encephalitides (e.g., anti-NMDA receptor encephalitis), Rasmussen encephalitis

• Infectious: chronic CNS infection (e.g., toxoplasmosis, malaria, neurocysticercosis) or complication of acute CNS infection (e.g., viral or bacterial meningitis or encephalitis