Do seizures cause brain damage?

Children with epilepsy are at significant risk for cognitive impairment and behavioral abnormalities. In most children with epilepsy, the likely reason for cognitive impairment is the underlying pathology responsible for the seizures. However, there is considerable controversy about whether seizures per se can cause brain damage or increase subsequent susceptibility to seizure. Although some longitudinal studies have related a decline in intellectual abilities to continued seizures, other studies indicate that treatment with antiepileptic drugs or progression of the encephalopathic process is responsible for the decline. Both clinical and animal studies have focused on the long-term effects of seizures on the developing brain. Whereas prolonged seizures may cause permanent neurologic sequelae in the mature animal, the immature brain may be more resistant to the long-term sequelae of seizures.