In recent years, epileptology scientists have been arguing about whether there are “pure” forms of epilepsy: only genetically predetermined or only due to some organic defect. It is generally recognized that during idiopathic epilepsy there are no pathomorphological changes in the brain.
This conclusion is based on in vivo studies and the statement that generalized idiopathic epilepsy is a functional disorder of neurophysiological mechanisms. However, the possibility of combining a genetically determined form of epilepsy and brain damage under the influence of exogenous factors should not be denied a priori.
Publications from some studies suggest a possible symptomatic nature of some forms of idiopathic epilepsy. Ex. Janz (1962)
published the results of a study of epilepsy with bouts grand mal.
Although epilepsy with bouts of grand mal awakening is an idiopathic generalized epilepsy with a genetic predisposition, in some cases, exposure to exogenous pathogenetic factors cannot be ruled out.
The author showed that in 10% of epilepsy cases of grand mal awakening, the symptomatic nature of the disease (perinatal pathology, trauma, tumor) was detected.
In addition, in recent years, it has been shown that patients with typical symptoms of organic brain damage and a diagnosis of symptomatic epilepsy with EEG recording show high frequency markers of genetic predisposition, such as generalized spike-wave complexes, photoparoxysmal reaction. Their presence serves as a kind of indicator of the propensity to develop paroxysmal disorders and an increased risk of epilepsy.
Thus, epileptologists come to the conclusion that it is more correct to speak of “predominantly idiopathic” or “predominantly symptomatic” epilepsies, which in some cases implies multifactorial pathogenesis.