For nearly 80% of patients with epilepsy, the underlying etiology is unknown. The most common recognized causes of epilepsy are head trauma and stroke. Developmental and genetic defects are the cause of about 5% of cases of epilepsy. CNS tumors, CNS infections, and neurodegenerative diseases are other common causes. Other important causes of epilepsy are HIV infection or neurocysticercosis infection, primarily occurring in Latin America.

Isolated seizures that are not epilepsy can be caused by stroke, CNS trauma, CNS infections, metabolic disturbances (e.g., hyponatremia, hypoglycemia), and hypox-ia. If these underlying causes of seizures are not corrected, they may lead to the development of recurrent seizures or epilepsy. Medications can also cause seizures. Some drugs that are commonly associated with seizures include tramadol, bupropri-on, theophylline, some antidepressants, some antipsychotics, amphetamines, cocaine, imipenem, lithium, excessive doses of penicillins or cephalosporins, and sympathomimetics or stimulants.

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