John Libbey Eurotext

The aetiologies of epilepsy Volume 23, issue 1, February 2021

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Authors
1 UCL Queen Square Institute of Neurology, Member of the ERN EpiCARE, London, UK
2 Chalfont Centre for Epilepsy, Bucks, UK
3 Department of Paediatric Clinical Epileptology and Functional Neurology, University Hospitals of Lyon (HCL), Member of the ERN EpiCARE, Lyon, France
4 Epilepsy Research Program, Epilepsy Unit, San Juan de Dios Paediatric Hospital, Member of the ERN EpiCARE, Barcelona, Spain
5 Institute of Neuropathology, University Hospitals Erlangen, Collaborating Partner of the ERN EpiCARE, Erlangen, Germany
6 University of Melbourne, Austin Health and Royal Children's Hospital, Florey and Murdoch Children's Research Institutes, Melbourne, Australia
7 Cumming School of Medicine, University of Calgary, Canada
8 Sahlgrenska Academy and University Hospital, Member of the ERN EpiCARE, Gothenburg, Sweden
9 Wallenberg Center for Molecular and Translational Medicine, Gotenburg, Sweden
* Correspondence: Simona Balestrini UCL Queen Square Institute of Neurology, Queen Square London WC1N 3BG, UK Matthew Walker UCL Queen Square Institute of Neurology, Queen Square London WC1N 3BG, UK

The identification of the aetiology of a patient's epilepsy is instrumental in the diagnosis, prognostic counselling and management of the epilepsies. Indeed, the aetiology can be important for determining the recurrence risk of single seizures and so for making a diagnosis of epilepsy. Here, we divide the aetiologies into six categories: structural, genetic, infectious, metabolic, immune (all of which are part of the International League Against Epilepsy [ILAE] classification system) and neurodegenerative (which we have considered separately because of its growing importance in epilepsy). These are not mutually exclusive categories and many aetiologies fall into more than one category. Indeed, genetic factors probably play a role, to varying degrees, in the risk of seizures in all people with epilepsy. In each of the categories, we discuss what we regard as the most important aetiologies; importance being determined not only by prevalence but also by clinical significance. The introduction contains information suitable for level 1 competency (entry level), whilst the subsequent sections contain information aimed at level 2 competency (proficiency level) as part of the new ILAE competency-based curriculum. As we move towards precision medicine and targeted therapies, so aetiologies will play an even greater role in the management of epilepsy.

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