II. Causes: New Onset Secondary Seizure Causes by age

  1. Age under 10 years
    1. Febrile Seizure (under age 5 years)
    2. Idiopathic
    3. Congenital
    4. Birth Injury
    5. Head Trauma (including due to Child Abuse)
    6. Metabolic disorder
      1. Hypoglycemia
      2. Hyponatremia
      3. Hypocalcemia
      4. Hypomagnesemia
  2. Age 10 to 40 years
    1. Idiopathic
    2. Head Trauma
    3. Pre-existing focal brain disease
    4. Drug Withdrawal
  3. Age 40 to 60 years
    1. Brain Tumor
    2. Head Trauma
  4. Age over 60 years
    1. Prior Cerebrovascular Accident (32%)
    2. Brain Tumors (14%)
    3. Subdural Hematoma
    4. CNS Infection (Meningitis or Encephalitis)
    5. Alzheimer's Dementia
    6. Metabolic abnormalities
      1. Uremia
      2. Hyperglycemia or Hypoglycemia
      3. Hyponatremia
      4. Alcohol Withdrawal

III. Causes: Non-Epileptic Causes of Seizure

  1. Idiopathic (most common, accounts for >80%)
    1. Isolated unprovoked, non-epileptic Seizure
  2. Neurogenic
    1. Brain Tumor
    2. Cerebral dysgenesis
    3. Cerebrovascular degenerative disorders
    4. Head Trauma
    5. Migraine Headache
    6. Movement Disorder
  3. Cardiogenic
    1. Syncope
    2. Transient Ischemic Attack
    3. Arrhythmia
    4. Sick Sinus Syndrome
  4. Electrolyte
    1. Hypocalcemia
    2. Hyponatremia (Water Intoxication)
    3. Hypomagnesemia
  5. Metabolic disorders
    1. Abnormal Glucose (especially Hypoglycemia)
    2. Hyperthyroidism (Thyroid Storm)
    3. Vitamin B6 deficiency
    4. Acute Renal Failure (Uremia)
    5. Acute Liver Failure
  6. Infectious disease
    1. Gram NegativeSepsis
    2. Viral Meningitis or Viral Encephalitis
    3. Bacterial Meningitis
    4. Cysticercosis
  7. Miscellaneous
    1. Fever (see Febrile Convulsions)
    2. Hyperthermia
    3. Psychogenic Nonepileptic Seizure (or Pseudoseizure)
    4. Sleep Disorder

IV. Causes: Medications and Drugs (and their withdrawal)

  1. Medications (especially if in overdosage)
    1. See Toxin-Induced Seizure Causes
    2. Antipsychotics (esp. Clozapine, Chlorpromazine)
      1. Avoid high dose, or in those with Seizure disorder or brain disorder
    3. Antibiotics (primarily with high doses, or if not adjusted for renal Impairment)
      1. Beta-lactam antibiotics (e.g. Penicillins)
      2. Cephalosporins
      3. Quinolones (e.g. Ciprofloxacin)
    4. Bupropion (Wellbutrin)
      1. Do not exceed maximum dose
      2. Avoid in Eating Disorder (e.g. Bulimia, anorexia), Seizure disorder, electrolyte disturbance
    5. Cyclosporine (Sandimmune)
    6. Interferon
    7. Isoniazid (INH)
    8. Lithium
    9. Meperidine (Demerol)
    10. Tacrolimus
    11. Theophylline
    12. Tramadol (Ultram)
      1. Avoid combinations with Alcohol or other agents predisposing to Seizure (e.g. Bupropion)
    13. Quinolone antibiotics
  2. Drug Withdrawal
    1. Alcohol Withdrawal
    2. Benzodiazepine Withdrawal
    3. Cocaine withdrawal
    4. Barbiturate withdrawal
    5. Meperidine withdrawal
  3. Drug or Metal toxicity
    1. Cocaine
    2. D-Amphetamine
    3. Nitrous Oxide
    4. Acetylcholinesterase Inhibitor
    5. Mercury Poisoning
    6. Lead Poisoning
    7. Intravenous Contrast material

V. References

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