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5 Common Causes of Epilepsy

August 07, 2025

Epilepsy affects millions of people, but it’s often misunderstood.

This brain disorder causes recurring seizures – sudden bursts of electrical activity that cause symptoms ranging from confusion or muscle twitches to full-body convulsions.

“While a single seizure can have many causes, epilepsy is diagnosed when someone has two or more unprovoked seizures,” says Gabriel Martz, MD, a neurologist and director of the Ayer Neuroscience Institute Epilepsy Center.

So what causes epilepsy – and why does it affect people so differently? Here’s what to know.

1. Genetics can play a role.

Some types of epilepsy are inherited – especially when there’s no clear injury, infection or other trigger.

“Genetic epilepsy can run in families, but it’s not always straightforward,” says Dr. Martz. “Different gene mutations affect the brain in different ways, and we’re still learning how those connections work.”

> Related: 4 Tips for Managing Your Epilepsy

2. Brain damage can lead to epilepsy.

Any injury that affects brain structure can interfere with its normal electrical signals – leading to seizures over time.

“This can include stroke, traumatic brain injury or tumors,” says Dr. Martz. “Even something that happened years ago, like a birth injury, can play a role.”

Common structural causes include:

• Birth complications.
• Head trauma.
• Brain tumors.
• Stroke or bleeding in the brain.

> Related: 6 Things to Know About Epilepsy and Seizures

3. Infections and autoimmune conditions can be triggers.

Serious brain infections – such as meningitis or encephalitis – can cause long-term inflammation and scarring that can lead to seizures.

“In some cases, the infection itself passes but leaves behind changes in the brain that increase seizure risk,” says Dr. Martz.

Other times, the body’s immune system can target the brain – resulting in inflammation and seizures.

4. Sometimes, the cause is unknown.

In many cases, the exact cause of epilepsy can’t be found, even after testing.

“We don’t always get a clear answer, and that can be hard for people to accept,” Dr. Martz explains. “But not having a known cause doesn’t make epilepsy any less valid or treatable.”

5. Lifestyle and environment matter.

While lifestyle isn’t a direct cause of epilepsy, certain habits and environments can raise the risk – especially if they involve head injury or drug use.

“Protecting your brain is one of the best ways to reduce preventable risk,” says Dr. Martz. “Things like avoiding substance use and wearing a helmet really do make a difference.”

> Related: Can the Keto Diet Treat My Epilepsy?

When to see a doctor.

If you or a family member experiences a first time seizure, it’s important to talk to your doctor to determine if additional testing or treatment with medication is needed.

At your visit, your provider may recommend tests such as:

• MRI to check for brain abnormalities.
• EEG to measure brain activity.
• Bloodwork to check for infections or underlying triggers.

Epilepsy affects each person differently – not just in how it shows up, but in how it shapes daily life.

“It affects people in very personal ways – from how they function day to day to how they feel emotionally,” says Dr. Martz. “Understanding what’s behind it is a key part of helping people live full lives.”