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Etiology

• Seizures are caused by a shift in the normal balance of excitation and inhibition within the CNS.
• SE occurs in 3 general clinical scenarios.
  • SE precipitated by focal or global CNS injury
    • Head trauma
    • Metabolic disturbance (e.g., hyponatremia, hypoglycemia)
    • Infection (encephalitis, abscess)
    • Drugs (both prescription and illicit)
    • Brain tumor
    • Stroke (acute or remote), hypoxia
  • SE as initial presentation of a seizure disorder
  • SE as exacerbation of known epilepsy
    • Primary risk factor is noncompliance with medications.
    • More common in patients with prior history of SE

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