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CAUSES OF SEIZURES AND EPILEPSY-SowjanyaRoll no.23Three clinical observations emphasize how a variety of factors determine why certain Conditions may cause seizures or epilepsy in a given patient-

1)The normal brain is capable of having a seizure under the appropriate circumstances andThere are differences between individuals in the susceptibility or threshold for seizures.

2)There are a variety of conditions that have extremely high likelihood of resulting in a Chronic seizure disorder,for example a severe penetrating head trauma

3)Seizures are episodic. Patients with epilepsy have seizure intermittently and depending upon the underlying cause many patients may be normal for few months to years This implies there are important provocative and precipating factors that induce seizures Precipitants include those due to intrinsic physiological processes such as psychological or physical stress,sleep deprivation or harmonal changes associated with menustral cycle.

These observations emphasize that many causes of seizures and epilepsy result from a dynamic interplay between endogenous,epileptogenic and precipitating factors. The potential role of each should be carefully considered when determining the appropriate management of patient with seizures.

Primary generalized epilepsy, e.g. JMEDevelopmental, e.g. hamartomas, neuronal migration abnormalitiesHippocampal sclerosisBrain trauma and surgeryIntracranial mass lesions, e.g. tumour, neurocysticercosisVascular, e.g. cerebral infarction, AVMEncephalitis and inflammatory conditions, e.g. herpes simplex, MSMetabolic abnormalities, e.g. hyponatraemia, hypocalcaemiaNeurodegenerative disorders, e.g. AlzheimersDrugs, e.g. ciclosporin, lidocaine, quinolones, tricyclic antidepressants, antipsychotics, lithium, stimulant drugs, e.g. cocaineAlcohol withdrawalCauses of epilepsyNeonates (1 month and 35 years)Cerebrovascular diseaseBrain tumorAlcohol withdrawalMetabolic disorders (uremia, hepatic failure, electrolyte abnormalities, hypoglycemia, hyperglycemia)Alzheimer's disease and other degenerative CNS diseasesIdiopathic

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