This page covers the causes of epilepsy – genetic, structural and metabolic, unknown, and in infant epilepsy.
The causes of epilepsy generally fall into three groups:
- Genetic
- Brain structure and metabolic (essential chemical processes in the body)
- Unknown – the majority of epilepsies, around 60%, presently have no known cause
Genetic causes
It’s important to note that when talking about causes of epilepsy, ‘genetic’ does not mean the same thing as ‘inherited’ from a parent.
Most genetic causes are the result of a gene mutation (difference) occurring in a person. Very few epilepsies are inherited and there is often no family history of epilepsy.
The types of epilepsy known to have a genetic cause include:
- Self-limited epilepsy with centro-temporal spikes (SeLECTS), previously known as benign rolandic epilepsy
- Temporal lobe epilepsy
- Juvenile myoclonic epilepsy
- Juvenile absence epilepsy
Other genetic conditions are known to cause epilepsy, e.g. tuberous sclerosis, a rare genetic disease that causes non-cancerous tumours to grow in the brain and on other vital organs.
In around three in every four cases of tuberous sclerosis, the genetic difference occurs for no apparent reason in people who have no family members with the condition.
In the remaining one in four cases, the gene mutation (difference) is passed on to a child by a parent.
If I have epilepsy, will my child inherit it?
As noted above, most genetic causes of epilepsy are the result of a gene mutation (difference) that occurs in the person and not inherited from a parent.
Very few epilepsies are inherited and, often, there is no family history of epilepsy.
It’s impossible to say for sure whether your child will inherit epilepsy because you have it.
This is because there are so many types of epilepsy and so many different factors that can affect whether your child inherits it or not.
Some people’s brains are naturally less able to cope with a burst of electrical activity.
This is known as a low seizure threshold. It’s thought this has a genetic cause.
One of our research projects is currently looking into the link between genes and epilepsy.
Speak to your GP
If you are a parent and have epilepsy and are concerned that your child might inherit epilepsy, you should speak to your GP, who will refer you to a specialist epilepsy team.
The specialist team will know what type of epilepsy you have and whether it’s a type that runs in families.
They can also carry out genetic testing and, if needed, refer you to a genetic counsellor, who will able to give you much more precise information.
Find out more about genetic and genomic testing.
Structural and metabolic causes
Epilepsy can be caused if:
- Brain cells are damaged (structural)
- There’s a disturbance in the delicate balance of chemicals in the body needed to produce electrical discharges (metabolic)
Some of the specific causes are:
- Damage to the brain during development in the womb or at birth
- Bleeding in the brain
- Infections in the brain
- Head injury
- Growths or tumours in the brain
- An underlying brain condition
- Stroke
- Metabolic conditions such as hypoglycaemia (low blood sugar) or abnormal calcium metabolism
- Drugs and alcohol
The causes of epilepsy in infants and babies
Epilepsy in infants and babies is different to epilepsy in older children and adults, because the brain is immature and developing rapidly.
Some babies and young children will experience seizures for a short time only.
For others, the seizures may return later on.
In some cases, they can continue throughout childhood.
As with epilepsies in older children, the causes fall into three groups:
- Genetic, e.g. tuberous sclerosis
- Structural and metabolic
- Unknown – in 60% of cases
Structural and metabolic causes in babies and infants
The most common causes include:
- Premature birth, which can cause haemorrhages (bleeds) in the brain tissue
- Birth trauma, which can result in hypoxia (low oxygen levels) and damage to brain tissue
- Serious infections affecting the brain
- Abnormal development of the brain’s structure during pregnancy
Is it epilepsy?
It can be difficult to diagnose the cause of seizures in babies and infants.
They can experience unexpected attacks affecting their movement, breathing or alertness for other reasons, e.g. benign neonatal sleep myoclonus (repetitive myoclonic jerks that occur during sleep, usually from birth to six months old).
From around six months to six years of age, febrile seizures (also called ‘febrile convulsions’) may occur. These seizures happen when a child has a fever or temperature.
If, however, epilepsy is diagnosed and the cause is known, your child’s doctor will be better able to predict how your child will develop and the outlook for managing their seizures.
Find out more about epilepsy treatments.
