Patty McGoldrick NP, MPA: So what causes epilepsy? There's a bunch of different things that can cause epilepsy. The simpler things are things like strokes, bleeding in the brain, parts of the brain that have formed abnormally, accidents, trauma. There are also idiopathic epilepsies, where we don't know what they're caused by. We're doing a lot of genetic research into epilepsy to find out what causes certain syndromes of epilepsy.
Steve Wolf MD: Now you mentioned the brain not developing properly, and sometimes we use the word "cortical dysplasia" or "migration defects." This is when the brain, when it's forming inside the mother's belly, that the brain just doesn't form properly and leaves an island of abnormal cells that can cause short circuits.
Patty: And there are certain diseases, things like tuberous sclerosis and neurofibromatosis that have abnormalities in the brain and the skin at the same time so that you can tell if a person has certain types of birthmarks, they're more liable to have something abnormal on the brain as well.
Steve: So these two different types of epilepsies are best detected by MRI, because they can look at the structure of the brain and tell us if those are the causes. We can look at the skin to see if there's anything going on. But tell me about the idiopathic ones.
Patty: The idiopathic ones are the ones that arise in childhood. So there are a certain number of epileptic encephalopathies that happen in infancy. And we're not really sure why children get them. There's absence that occurs in early childhood. There's benign rolandic. That's another syndrome. And then there are, of course, there's autism which is associated with a very high percentage of epilepsy and seizures. And we're doing a lot of genetic testing to look at what the genetic basis is for epilepsy.
Steve: So in this idiopathic group, I find so fascinating, is that genetics is going to play a lot in the future. And soon we will be able to do more testing to find out what is the genetic abnormality that's causing these seizures, and that might help us to make the diagnosis.
Patty: The other thing is that we tend to think of epilepsy as one disease, and it's really not. It's multifactorial. There are a lot of different causes for it. There are a lot of different types of seizures. So as our technology gets better and as our treatments get better, we'll have a much better idea of what actually causes epilepsy beyond the things that we've always known.