In most patients with epilepsy, the etiology remains unclear. According to an epidemiological survey in Rochester, New York, 65% of cases are idiopathic or cryptogenic. The most frequent cause of epilepsy is vascular disorder (10%), followed by congenital complications (8%), brain trauma (6%), tumor (4%), degenerative disorders (4%), and infectious diseases (3%). The etiology of epilepsy is largely dependent on the age of onset, with congenital disorders dominating in childhood epilepsies, trauma and tumors being most common in early adulthood, and cerebrovascular and degenerative disorders becoming more frequent with older age. Recent studies using advanced imaging techniques have revealed a high number of patients with subtle cortical dysgenesis or hippocampal sclerosis—patients who were formerly classified as cryptogenic.

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