Infection and inflammation

Seizures and epilepsy may occur secondarily to a wide range of infectious (parasites, bacteria, viruses, or fungi) and inflammatory diseases of the central nervous system, either as the primary manifestation or as part of a diffuse encephalopathy. The pathogenesis and clinical expression of the seizure disorder vary widely from one disease to another, and even across different types of infection with the same agent. While a myriad of infective agents invading the central nervous system may cause seizures, most frequent causes include cerebral malaria, neurocysticercosis, bacterial meningitis or encephalitis, bacterial abscesses, tuberculosis, viral encephalitis, and cryptococcosis. Seizures may also be associated with inflammatory, noninfectious disorders including Rasmussen encephalitis and neurosarcoidosis. Treatment of seizures associated with infection or inflammation usually involves symptomatic management, including antiepileptic drug therapy, and treatment for the underlying disorder. Recognition of infectious- or inflammatory-related acute or remote symptomatic seizures has important therapeutic and prognostic implications.