Causes of Epileptic Seizures

Epileptic seizures can be triggered by a variety of factors. These include brain tumors, traumatic brain injuries, encephalitis, cortical dysplasia, and genetic predispositions. To accurately diagnose the underlying cause, patients are typically advised to undergo magnetic resonance imaging (MRI). Epilepsy can generally be classified into two categories: MRI-negative and MRI-positive.

Understanding MRI-Negative Epilepsy

For patients with MRI-negative results—meaning no visible structural abnormalities are detected—oral anti-seizure medications are often the first line of treatment. Studies show that this approach can be effective in more than 70% of cases. While the exact cause of seizures in these patients may remain unclear, drug therapy remains a viable and often successful option.

Insights Into MRI-Positive Epilepsy

Conversely, MRI-positive epilepsy refers to cases where imaging clearly reveals abnormalities such as developmental issues or the presence of a tumor. In such situations, it is crucial for patients to seek evaluation at a specialized epilepsy surgical center. Even with consistent use of antiepileptic drugs, the likelihood of achieving full seizure control is generally less than 50%.

Considering Surgical Intervention

For these patients, surgical removal of the affected area may be recommended. This intervention can significantly improve long-term outcomes and reduce the frequency or even eliminate seizures altogether. Early assessment by a multidisciplinary team is essential to determine the best course of action.

Conclusion and Recommendations

In summary, while the causes of epileptic seizures are diverse, identifying the underlying condition plays a crucial role in determining the most effective treatment. Patients with secondary causes such as tumors or cortical malformations should consider a surgical evaluation. Those with MRI-negative epilepsy can often find relief through medication at a reputable tertiary hospital, with many experiencing positive results and improved quality of life.