Patient's question:
When the child was 5 years old, while playing with peers on the bed, he fell off and hit his head on the ground. He was immediately taken to the hospital for treatment. A few days ago, he suddenly fainted, had convulsions in his hands and feet. Relatives said it might be epilepsy, and he is currently undergoing an EEG examination.Doctor's answer:
There are many causes of epilepsy, including focal brain lesions or diffuse brain abnormalities, as well as systemic metabolic poisoning. Some causes remain unknown to this day. In clinical practice, 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 about 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 small number of patients after brain trauma, approximately 5% of patients experience seizures after such injuries. However, among those who develop epilepsy early after brain trauma, about one-fourth may later experience seizures. Brain injuries caused during childbirth are also 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. Particularly 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 can cause abnormal discharges under endogenous or exogenous stimuli, triggering epilepsy. Another group of pediatric patients develops epilepsy due to vascular malformations. Additionally, some patients may experience epilepsy as a result of intracranial bacterial or viral infections, leading to conditions such as encephalitis, meningitis, arachnoiditis, or brain abscesses.
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 vitamin B6 deficiency, among others. These conditions may all trigger epilepsy.