Idiopathic epilepsy is a type of generalized epilepsy and includes several subtypes. Certain genetic mutations may play a role in idiopathic epilepsy, and stress, a lack of sleep, and excess alcohol consumption may trigger seizures.

Idiopathic epilepsy is a subtype of generalized epilepsy. This subtype does not present with structural brain changes or other signs of epilepsy on imaging scans or similar diagnostic tests. Doctors may also refer to idiopathic epilepsy as genetic generalized epilepsy (IGE).

Around one-third of people with epilepsy may have a form of idiopathic epilepsy, which includes the following types of epilepsy:

  • juvenile myoclonic epilepsy (JME)
  • childhood absence epilepsy (CAE)
  • juvenile absence epilepsy (JAE)
  • IGE with generalized tonic-clonic seizures

JME is the most common type of idiopathic epilepsy and may occur in around 3–11% of cases in adolescents and adults.

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Three main types of seizures occur with idiopathic epilepsy:

People may have one type of these seizures or a combination.

Symptoms may vary depending on the type of idiopathic epilepsy and seizure type a person has.

Generalized tonic-clonic seizures may cause:

  • a sudden loss of consciousness, with no aura
  • stiffening of the body
  • bluish coloring or discoloration of the skin
  • jerking movements
  • sleepiness, confusion, or agitation after a seizure

Absence seizures may cause:

  • a temporary lack of awareness, such as a person not being aware someone is talking to them
  • a pause in whatever the person is doing, such as talking and stopping midsentence
  • confusion, at temporarily missing what was happening in the present moment
  • a return to clear thinking and alertness once the seizure is over
  • multiple absence seizures may occur in a row

Myoclonic seizures may cause:

  • irregular or shock-like movements in both arms
  • movement may only occur in the fingers, which may make people drop things or appear clumsy
  • myoclonic jerks may only occur on one side of the body in some people

Learn more about types of seizures.

Idiopathic epilepsy may occur due to certain genetic changes, which may involve changes in chromosomes. However, it is rare for genetic mutations to cause epilepsy.

Imaging scans, such as MRI scans, show no structural brain lesions in people with idiopathic epilepsy nor any evidence of other symptoms or signs between seizures.

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Family history may be a risk factor for certain types of idiopathic epilepsy. In children with CAE, around 1 in 3 have a family history of absence or generalized seizures. People with a sibling with CAE have roughly a 1 in 10 likelihood of developing epilepsy.

Around 50–60% of people with JME have a family history of seizures. Lack of sleep, stress, and drinking excess alcohol are also common triggers of JME. Light, such as strobe lighting or bright sunlight, may also trigger seizures in some people.

Individuals with JAE may have family members who have similar seizures or generalized epilepsy, but a family history is rare.

Learn more about the role of genetics in epilepsy.

A doctor may use a range of tests to rule out other causes of epilepsy and diagnose idiopathic epilepsy. This may include:

A doctor will also take a thorough medical history, including family history, and consider seizure history, including:

  • types of seizures
  • timing
  • triggers
  • age of onset

After assessing seizure history and finding a lack of signs of epilepsy through examinations, a doctor may diagnose idiopathic epilepsy.

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Treatment for idiopathic epilepsy aims to control seizures. The main treatment is antiepileptic medication (AEDs), with the first-line drugs being:

Other AEDs which people may use for idiopathic epilepsy include:

Learn more about AEDs and their side effects.

Complications of idiopathic epilepsy may include status epilepticus, which is a seizure lasting for longer than 5 minutes or two seizures occurring together in quick succession without recovery in between.

Nonconvulsive status epilepticus is more common in idiopathic epilepsy than convulsive status. Status epilepticus requires emergency treatment, but nonconvulsive usually responds quickly to intravenous benzodiazepine treatment.

Sudden unexpected death in epilepsy is a fatal complication of the condition but may be less of a risk with idiopathic epilepsy than with symptomatic epilepsy.

Other possible risks or complications of epilepsy include:

  • falls or injury during seizures
  • side effects of AEDs
  • increased risk of bone issues
  • cognitive or memory problems
  • social concerns about epilepsy affecting everyday life and relationships
  • sleep issues
  • mood disorders

There is currently no cure for epilepsy, but AEDs may help control seizures in people with idiopathic epilepsy.

Sodium valproate may be the most effective treatment option for generalized seizures, with 75% of people becoming seizure-free while taking the medication.

Sodium valproate may also help prevent absence seizures from recurring and help people with photosensitivity.

Ethosuximide is almost as effective as sodium valproate and can help treat typical absence seizures. However, it does not prevent generalized tonic-clonic seizures or myoclonic seizures.

Lamotrigine can help control typical absence seizures and generalized tonic-clonic seizures. The drug also does not have the same risks in pregnancy as sodium valproate.

The outlook may vary depending on which type of idiopathic epilepsy people have, the age of onset, and the seizure type.

Idiopathic epilepsy does not show structural changes in the brain in imaging scans or other diagnostic tests. This subtype may have a genetic cause.

Idiopathic epilepsy is a type of generalized epilepsy and includes juvenile myoclonic epilepsy (JME), childhood absence epilepsy (CAE), juvenile absence epilepsy (JAE), and IGE with generalized tonic-clonic seizures.

Antiepileptic medications are the first-line treatment for idiopathic epilepsy, and in many cases, they may effectively control seizures and may allow people to be seizure-free.