Patient's question:
Symptom control, 3 months later, symptoms recurred, and Topiramate was taken again. Thereafter, attacks still occurred every half month. What are the causes of epilepsy? Why do seizures occur?Doctor's answer:
There are many causes of epilepsy, including focal brain lesions or diffuse brain abnormalities, systemic metabolic toxicity, and some causes that remain unknown. Clinically, common causes of epilepsy are particularly important, such as brain trauma, brain tumors, cerebrovascular diseases, intracranial infections, etc.① Brain Trauma: This includes open and closed brain injuries. Statistics show that approximately one-third of epilepsy patients have a history of head trauma. Without a doubt, brain trauma is one of the main causes of epilepsy. While epilepsy occurs in a minority of patients after brain trauma, about 5% of patients experience seizures after such injuries. However, among those who develop epilepsy early after brain trauma, about one-fourth may develop it later. Brain injuries caused during childbirth are a significant cause of epilepsy in children.
② Brain Diseases: This includes brain tumors, cerebrovascular diseases, intracranial infections, etc., which are also common factors that trigger epilepsy. Especially in adulthood, so-called late-onset epilepsy accounts for a relatively higher proportion. The growth of brain tumors can compress or affect surrounding brain tissue and blood vessels, leading to cerebral edema, swelling, hypoxia, ischemia, brain tissue hardening or atrophy. These metabolic abnormalities and changes in membrane potentials of neurons often result in abnormal discharges under endogenous or exogenous stimuli, triggering epilepsy. Another group of pediatric patients develop epilepsy due to vascular malformations. Additionally, some patients may experience epilepsy due to intracranial bacterial or viral infections, which can cause encephalitis, meningitis, arachnoiditis, brain abscesses, etc.
③ Epilepsy Caused by Systemic Factors: This includes carbon monoxide poisoning, hypoglycemia, acute or chronic renal failure, hypertensive encephalopathy, pancreatic adenomas, hypocalcemia, hyperthyroidism, and various systemic infections, as well as a lack of vitamin B6, etc. All of these can trigger epilepsy.