For over a century, the question of why certain brain lesions cause epilepsy while others do not has remained unanswered. Brain lesions are the primary identifiable cause of epilepsy in adults, particularly in individuals above the age of 55. However, it is intriguing to note that only a small percentage of people with stroke (6%), intracerebral hemorrhage (9%), and brain tumors (approximately 40%) develop lesional epilepsy. This raises the crucial question of why epilepsy occurs in some individuals with brain lesions and not in others. Further research is needed to unravel the underlying factors that contribute to this disparity and provide insights into preventing or managing lesional epilepsy more effectively.

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