What We Know About Heredity & Epilepsy

Patients with epilepsy considering parenthood are commonly concerned about passing the disease on to their children. Current research shows that there is only a slightly higher risk of epilepsy developing in children who have a parent with epilepsy than in those who do not. 

However, it is crucial to take your patient’s concerns about any potential hereditary impact of their disease seriously and listen to any anecdotal “evidence” they may present. Help them understand the available research around epilepsy and heredity and, when warranted, guide them to consider genetic counseling and testing as part of their pregnancy planning. 

Topics covered on this page include:

Known Hereditary Rates

For most patients with epilepsy, the risk of passing the disease to a child is only slightly higher than the risk of a member of the general population having a child with epilepsy (1-2%). Specifically, the hereditary rates for patients with:

  • Focal epilepsy is 1-5%
  • Any type of epilepsy is 3.5-6% 
  • Generalized epilepsy is 6-8%.

When to Recommend Genetic Counseling

Certain situations increase the likelihood of a parent passing epilepsy to their child. Refer your patient for genetic counseling and, when clinically indicated, genetic testing in cases of:

  • Periventricular nodular heterotopia (PVNH), a brain abnormality present in some individuals with epilepsy
  • An intellectual disability or autism in addition to epilepsy
  • A known genetic cause of their epilepsy
  • Sleep-related hypermotor epilepsy
  • A strong family history of epilepsy, including having any first-degree relatives or more than one second-degree relative with epilepsy

NOTE: The prenatal carrier screening test obstetricians and prenatal genetic counselors typically offer does not test for epilepsy.

Guide Your Patients

Patients considering whether or not to have a baby have real concerns about passing epilepsy on to their children. Although research shows the chances of this happening are low, treat their concerns with respect and understanding. 

When a patient’s circumstances may increase the likelihood of passing epilepsy to their children, work with them to understand genetic counseling and testing processes and what information testing will provide. 

Reviewed by: Laura Kirkpatrick, MD, August 2023