In some people, Epilepsy may be hereditary. But even if you have epilepsy, the chance that your child will have epilepsy is 5% or lower.
Epilepsy is inherited through abnormal epilepsy genes. These epilepsy genes may be dominant or recessive (explained below). So transmission of epilepsy can be dominant or recessive.
Genetic testing for epilepsy before pregnancy may be useful in the future. At present, genetic testing for epilepsy is rarely useful.
Table of Contents
Is Epilepsy a hereditary disease?
The word hereditary means passed on from Parents to Children.
People with Epilepsy can have abnormal genes. If you have epilepsy, some of your genes may be abnormal. These genes may be passed on to your children.
So, Epilepsy can be an inherited disease.
Parents pass on their DNA to their children.
How commonly is Epilepsy inherited?
Most children of patients with Epilepsy do not develop Epilepsy. It is unlikely that your child will have Epilepsy, even if you have Epilepsy.
Overall about 1% of babies are born with epilepsy.
If you have epilepsy, the chance increases but only slightly. About 5% of babies born to a parent with epilepsy will have epilepsy.
Overall, the chance that you will transmit epilepsy to your child is small.
For example: One Italian study looked at more than 10,000 people with Epilepsy. Only 2.5% of close relatives (parents, siblings, children) of these patients had epilepsy.
Therefore, in most cases the answer to the question “Is epilepsy a hereditary disease” is NO, epilepsy is not a hereditary disease.
The risk of your children getting Epilepsy is higher if:
You have one of the “Dominant” genes mentioned below.
You have an Epilepsy syndrome with only generalized seizures, e.g. JME.
Let us know more how epilepsy is inherited.
How is Epilepsy inherited?
Epilepsy is inherited through abnormal genes. Epilepsy genes are present in some people with epilepsy.
Many people with epilepsy do not have abnormal epilepsy genes. Many people have epilepsy due to causes such as old strokes or head trauma. These people cannot pass on epilepsy to their children. In these cases, it is incorrect to say that epilepsy is hereditary.
A stroke is caused by a blood clot in the brain. It can cause seizures. This form of epilepsy is not hereditary.
Even if you have an abnormal epilepsy gene, it is very unlikely that your children will have epilepsy.
Epilepsy genes can be Recessive or dominant. They can have incomplete penetrance. So, even if you have an abnormal epilepsy gene, it may be incorrect to say that epilepsy is hereditary.
Let us know more about the terms recessive genes, dominant genes and incomplete penetrace.
What are “Recessive” genes?
Let us assume that you have some abnormal genes. Still, it is unlikely that your child will have epilepsy.
Why is it so? It is because your child will receive two sets of genes. One set from you and another from your partner.
The egg has 23 chromosomes. The sperm has 23. They combine, and the baby gets 46 chromosomes!
Even if one of these sets is normal, the child will not have Epilepsy. The normal genes prevent the harmful effect of abnormal genes.
These abnormal genes are called “Recessive”. Luckily, many of the genes causing Epilepsy are Recessive.
So, even though epilepsy is a hereditary disease if you have recessive genes – very few members of the family actually develop epilepsy.
What are “Dominant” genes?
Some genes are “Dominant” in nature. This means that even if onlyone set of genes is faulty, the child can develop Epilepsy.
If you want, you can click on the plus sign below. You will see the known Dominant genes causing Epilepsy.
This table seems large! But very few people have these genes. Most people have “recessive” epilepsy genes.
Dominant Epilepsy genes
Abnormal Gene
Mechanism: Which channel is affected
Epilepsy Syndrome that it produces
KCNQ2, 3
Abnormal Potassium channels on cells
Benign Familial Neonatal Convulsions
SCN2A
Abnormal Sodium channels
Benign Familial Neonatal-Infantile Seizures
SCN1A, 2A, 2B, GABRG2
Same as above
Generalized Epilepsy with Febrile Seizures Plus (GEFS+)
Autosomal Dominant Epilepsy with Auditory features (ADEAF)
Unknown (?GABRG2)
Unknown
Familial Mesial Temporal Lobe Epilepsy (FMTLE)
DEPDC5
Abnormal signalling pathways inside cells
Familial Focal Epilepsy with Variable Foci (FEVF)
*Non-italic = These genes may produce both focal or primary generalized epilepsy. Italic = produce only focal epilepsy.
So, epilepsy is more likely to affect your family members (including children) if you have a dominant epilepsy gene. But even that is not a 100% certainty.
If I have a Dominant epilepsy gene, will my child have Epilepsy?
Even if you have a “Dominant” epilepsy gene, your child may not have Epilepsy.
Sometimes abnormal genes do not cause an abnormal effect, even if they are dominant. “Incomplete penetrance” is the medical term for this phenomenon.
The reasons for “Incomplete penetrance” are difficult to explain. You can read more by clicking here.
Even if many children have a dominant epilepsy gene, only a few develop epilepsy. This is called “incomplete penetrance”.
But who’s arguing with nature! Incomplete penetrance is very beneficial.
Let us look at the other genes described above. Notice that it is difficult to calculate the exact chance of transmission. If you’re intersted, here is a research paper discussing this problem.
Penetrance of Dominant Epilepsy genes
Abnormal Gene
Epilepsy Syndrome that it produces
Chances that your Child will have Epilepsy
KCNQ2, 3
Benign Familial Neonatal Convulsions
80%
SCN2A
Benign Familial Neonatal-Infantile Seizures
Variable
SCN1A, 2A, 2B, GABRG2
Generalized Epilepsy with Febrile Seizures Plus (GEFS+)
Autosomal Dominant Epilepsy with Auditory features (ADEAF)
Variable
60 – 80%
Unknown (?GABRG2)
Familial Mesial Temporal Lobe Epilepsy (FMTLE)
60%
DEPDC5
Familial Focal Epilepsy with Variable Foci (FEVF)
60%
So even if you have a dominant epilepsy gene, Epilepsy may still not be a hereditary disease!
Is Epilepsy more likely to be transmitted if the Parents are related?
Usually, parents have very different genes from one another. The child does get two sets of genes, one from each Parent. Even if one is an abnormal epilepsy gene, the other is frequently normal.
So Epilepsy transmission to the child is not common.
Marriages between close relatives (e.g. cousins) are called “consanguineous Marriages”.
Weddings between cousins are common in some cultures.
If the two parents are related to each other (e.g. are Cousins), then they are genetically similar. They have similar genes.
Both may have the same abnormal epilepsy gene. Their child may get two sets of abnormal epilepsy genes. A child with two sets of abnormal epilepsy genes can develop epilepsy.
So, Epilepsy is more likely to be a hereditary disease if the parents are closely related.
Is Genetic Testing for epilepsy before pregnancy useful?
Doctors don’t agree about genetic testing for Epilepsy before pregnancy. Usually, genetic testing for epilepsy before pregnancy is not helpful.
Genetic testing checks whether you have an abnormal epilepsy gene. If you have an epilepsy gene, perhaps your doctor can estimate the chance that your child will have epilepsy.
But genetic testing is frequently useless.
Here is why:
We don’t know all the genes that cause Epilepsy. So a negative result means nothing.
Let’s say we do find an abnormal gene. Still, the chance of the child getting epilepsy is variable. (see “incompelte penetrance” & table above).Testing for epilepsy genes before pregnancy is reasonable only in special cases.
I don’t enthusiastically advise genetic testing before pregnancy. I discuss it in 3 scenarios:
If your spouse is related (e.g. cousins).
There is a strong history of epilepsy in your family.
You have a epilepsy syndrome that is well-known to have a high chance of transmission.
There are other scenarios in which genetic testing may be useful:
It may identify your Epilepsy Syndrome.
It may disclose why your epilepsy is difficult to control.
It may help in selecting the right medications.
It may help in predicting the outcome of Epilepsy Surgery.
Epilepsy can be transmitted to children. But the chance is very low (5% or less).
This is because each child gets 2 sets of genes. 1 set from each parent. Usually, even if one set is normal the child does not develop Epilepsy (Recessive gene).
It is impossible to identify all genes causing epilepsy. It is impossible to calculate the exact risk of transmission.
I usually don’t recommend testing for epilepsy genes before pregnancy. There are 3 exceptions to this rule (see above).
Caution: This information is not a substitute for professional care. Do not change your medications/treatment without your doctor's permission.
Dr. Siddharth Kharkar
Dr. Siddharth Kharkar has been recognized as one of the best neurologists in Mumbai by Outlook India magazine and India today Magazine. He is a board certified (American Board of Psychiatry & Neurology certified) Neurologist.
Dr. Siddharth Kharkar is a Epilepsy specialist in Mumbai & Parkinson's specialist in Mumbai, Maharashtra, India.
He has trained in the best institutions in India, US and UK including KEM hospital in Mumbai, Johns Hopkins University in Baltimore, University of California at San Francisco (UCSF), USA & Kings College in London.
Out patient is epileptic from about 10 years and her seizure gotten worse during the past year with the frequency of about 3-4 times a week.So we consulted… More Dr. Kharkar. He tried a few medicines, and within 1.5-2 months now the patient is feeling very well now. There are no seizures for 14 days currently.Dr. tried to keep medicines as minimum as possible. He also tried to keep the cost of the treatment minimum.When some of the medicines started showing side-effects, he was quick to switch the medicines to the better options.Overall I think we are getting a best of the available treatments. We thank you very much Dr. Kharkar.
Dr. Kharkar is truly exceptional. He is extremely knowledgeable. But simultaneously, he is extremely patient and kind - taking the time and care to respond… More to all the questions. It is rare to come across a doctor who is not in a hurry to get on to the next patient, but instead, focuses on the one in front with full attention, expertise and compassion. A great experience.
One of the best Dr. Gives complete attention and time to listen to patient's history, issues. Explains various options of treatment with pros and… More cons.
I have been visiting Dr Kharkar for treatment of my father. He is a very friendly doctor. He listens to our concerns with lot of patience. He also explains… More the issue in much greater details. He has really been of great help. My father is much better now.
Dr Kharkar gives you all the time you need to hear you out in complete detail. He probes in depth to ensure he has managed to gain all data points to find… More the best way forward medically for you. He is an authority on the subject. After 4 years of suffering I have found my go to doctor
We visited Dr. Kharkhar for treatment regarding my mum - who is a multi-stroke patient and has aphasia. Certain medications were creating complications… More with her condition and Dr. Kharkhar was able to help mitigate the issue. We found him and his approach to be incredibly compassionate, considerate, individualized and patient-friendly. He advice is astute, up-to-date and empathetic. His treatment always comes from a deeply human place and is about seeing how to help the patient and their caregivers feel more at ease. Something that is quite rare and refreshing within the medical community.We feel that he genuinely cares about the patients that he is treating and is always kind and respectful in his communication. Moreover, his admin team is very efficient and prompt and it's a pleasure to deal with them.Would highly recommend Dr Kharkhar himself - though we must say our experience with Nanavati hospital itself has been less than ideal.Hope this helps.
Exceptional experience with an expert,Dr. Kharkar is a knowledge house. It is rare nowadays to find doctors with patience, knowledge, and a flair for… More handling patient’s questions, besides Dr. Kharkar’s bedside manners are exemplary. I am privileged to be treated by such an amazing soul. I have told him and will repeat it here that “I am advancing my move back to India although I am a US Citizen, because I know I am in good hands and will be well taken care of. Thanks Dr. Kharkar for your selfless service!
Great doctor!! Really appreciate.The doctor diagnosed to my sister correctly and start treatment, she has good improvement after taking medicine prescribed… More by doctor as no epilepsy attake. We have good experience with the doctor. Thank you
We have visited the hospital and meet the Dr. S. Kharkar. And my personal experience is very much better and exilent. My father is very well recover as… More we thought. Thanks to Nanavati Hospital and Dr. S. Kharkar.
The services that I received from doctor Siddharth kharkar is excellent ,and the other doctor is also very good who had taken initial discussion with me… More ...and the staff are friendly and ensure that I am properly informed about my health and care and would highly recommend to anyone..
Had very Severe migraine attacks for years and suddenly my migraine had triggered for continuous 5 days thats when I contact Dr Siddharth and was fortunate… More to have a effective medication which help me reduced my triggers and headaches..Lucky in few months I have very less days of headache in a month and can do my Daily life with much ease.
My experience with Dr Siddharth Kharkar was really awesome. It’s always great to be in the presence of someone who is a renowned expert in his field &… More it brings peace of mind that the advice will obviously be the correct one. In addition, his ability to convey complex workings of the human brain in such simple terms that a layman like me could easily understand was something I really appreciated. I heartily Thank Dr Kharkar for his astute advice & gladly recommend him to anyone who needs a neurologist.
Best Dr. we have ever meet. Dr. Listened to us patiently and gave us the proper solution. No unnecessary test or didn’t frighten us. Thank you so much… More Dr.
Great doctor!! Really appreciate.The doctor diagnosed me correctly and start treatment that will help me a lots to improve my condition. The doctor is… More really good, calm and his nature is down to earth, gives confidence to patient!!! Thank you!!!
We had been looking for a specialist in parkinsons for a while now, for my father and when we found Dr. Siddharth Kharka's details on Google, we were… More partly relieved. Partly because, we were all very anxious not knowing how would our visit turn out. I appreciate Dr. Kharkar and his team. He was very clear in his explanations, his knowledge about parkinsons. He took the time to answer the questions we had, went over the diagnosis and started necessary treatment immediately. The only drawback we experienced was the waiting time. Overall, we left the clinic satisfied, knowing much more than when we walked in. We would highly recommend him to anyone looking for a specialist.
I have visited the doctor clinic for the first timeBut he gave good advice and helped me overcomeMy doubts and queries. It was a good experience.I am very… More thankful for cooperation.
Hi Sharing my experience with Dr KharkarI had consulted with dr regarding my husband’sProblems of tremors. Dr immediately diagnosed on video consultation… More and could help him to control the tremors s of Parkinson’s disease.I found him genuinely polite and free to talk n patiently listening to the patients problem.Now my husband regained his balance n tremors controlled. Many many thanks to Dr Kharkar
Consultation with the doctor was a very satisfying experience. Was empathetic in his approach, and responded positively to all the queries we had. Thank… More you doctor!
Dr Siddharth is one of the best Dr I have ever met. He is kind, polite, helpful and very selfless person. I have migraine and I am his patient since more… More than 2 years. The staff is always helpful and Dr Siddharth is just beyond words for me. Thank you for ur selfless service and kindness u give to all ur patients.