Patient's question:
Because of fever and worry, I have fallen twice. I can no longer remember any falls. It seems like there hasn't been a major recurrence, and I don't remember lying on the ground. My grandfather had howling symptoms, sometimes feeling a bit like dozing off, but only once. There was also up-and-down head movements. Recently, my father was observed to have a moment of vacant staring and swallowing saliva, something I hadn't noticed before. It's unclear. Was it due to birth injury, fever, or genetics? Or could it be a combination of all three? How can the specific cause be determined?Doctor's answer:
Caused by poisoning and some with unknown origins. In clinical practice, common factors or causes of epilepsy include traumatic brain injury, brain tumors, cerebrovascular diseases, intracranial infections, etc.① Traumatic brain injury: Includes open and closed traumatic brain injuries. Statistics show that about one-third of epilepsy patients have a history of head trauma. There is no doubt that traumatic brain injury is one of the main factors or causes of epilepsy. Although epilepsy occurs in a minority of patients after traumatic brain injury, about 5% of patients experience epilepsy recurrence after the injury. However, among those who have early epilepsy recurrence after traumatic brain injury, they may account for one-fourth of those who have late epilepsy recurrence. Brain injuries caused during childbirth are an important factor or cause of epilepsy recurrence in children.
② Brain diseases: Including brain tumors, cerebrovascular diseases, intracranial infections, etc., are also common factors that trigger epilepsy recurrence, especially in cases of late-onset epilepsy in adulthood, where the proportion is relatively higher. The growth of brain tumors compresses or affects 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 nerve cells often result in abnormal discharges under endogenous or exogenous stimuli, triggering epilepsy. Another group of pediatric patients may develop epilepsy due to vascular malformations. Additionally, some patients may experience epilepsy recurrence due to intracranial bacterial or viral infections, leading to conditions such as encephalitis, meningitis, arachnoiditis, or brain abscesses.
③ Epilepsy caused by systemic factors, such as 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, etc., may all trigger epilepsy recurrence.