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Epilepsy is a relatively common medical problem. Dr. Anton Titov, MD. Epilepsy is also called epileptic seizure disorder. What are major causes of new onset of epileptic seizures? Are causes of new-onset epileptic seizures different in different age groups? Dr. Tracey Milligan, MD. Epilepsy is one of the most common neurologic disorders. Dr. Anton Titov, MD. It is the fourth most common neurologic disorder. one in twenty-six patients will develop epilepsy in their lifetime. Why they develop epilepsy? Why they have their first epileptic seizure? It really does vary depending on the age group. Dr. Tracey Milligan, MD. There are two most common time periods for patients to develop epilepsy. One time period is during the first year of life of a person. Dr. Anton Titov, MD. Those are babies who suffer some trauma in childbirth. There are also small children who have a genetic or congenital cause for epilepsy. Cause of epileptic seizures may be a metabolic disease or structural brain disease. Injury to the brain or an infection can cause epilepsy. Other injury that happened during birth can also cause epilepsy. The second most common time period when patients develop epilepsy is after the age of 60. The incidence of epileptic seizures rises with advancing age. The most common time for patients to develop epilepsy during their lifetime is after the age of 75. many patients don’t realize that. It is more common to develop epilepsy as people are getting older than at any other time in life. Dr. Tracey Milligan, MD. These are reasons why patients develop epilepsy when they are elderly. It is mainly due to some trauma that has happened to the brain over time. That could be a traumatic brain injury or a stroke. Trauma could be a vascular damage to the brain. Trauma could be a result of something that happened earlier in life. As the brain ages, it becomes more susceptible to having an epileptic seizure. Dr. Anton Titov, MD. Sometimes patients develop epilepsy as a result of a neurodegenerative disorder like Alzheimer disease. Dr. Tracey Milligan, MD. Those are two most common time periods for patients to develop epileptic seizures. But patients can develop epileptic seizures all through their life. People can develop epileptic seizures at any time of life. In teenage and young adult years, the most common cause of epilepsy is a genetic or congenital cause. The brain is constantly changing throughout our lifetime. It could be that defective gene was present even before birth. But that gene may not manifest itself with the epileptic seizure until the teen years or 20s. Seizures may appear even sometimes in early 30s. A trauma in the brain is another reason why patients develop epilepsy in their teens, 20s, 30s, 40s, 50s. Brain tumors are also a cause of new onset of epileptic seizures during adulthood. Dr. Anton Titov, MD. When patients do develop epileptic seizures, we want to look at the structure of the brain. Dr. Tracey Milligan, MD. We want to see if we can identify a cause. But sometimes epilepsy is explained by the genetics of the patient. It seems that genetic causes of epilepsy are so common. This is a common cause of epilepsy even when patients develop their first epileptic seizure in teenage years and in 20s and 30s. Dr. Anton Titov, MD. What events usually trigger the manifestation of a genetic problem? What events happen to patients that can trigger an epileptic seizure in a genetically-susceptible person? Dr. Tracey Milligan, MD. We are in Boston now. In Boston we have a lot of colleges and universities. A typical patient that we see in a Boston emergency room is a college student. This student is now in college and not sleeping as much. This student maybe is drinking alcohol. Sleep deprivation, alcohol use, stress of being away from home and being in a university can trigger an epileptic seizure in somebody who genetically susceptible to epilepsy. Dr. Tracey Milligan, MD. There is a syndrome called juvenile myoclonic epilepsy. Sometimes we see patients who have had that genetic disorder their entire lives. But then they come to college and have these additional stressors in their life. They also are older. Dr. Anton Titov, MD. That is when patients with juvenile myoclonic epilepsy first have a clinical epileptic seizure.