Cause of seizures?

I have an appointment set up for October 1st with a new doctor who is an epileptologist at a Level 4 center in Chicago. I set up this appointment in March. I met him in July via telehealth which I don't like. I had an MRI there and they said it was Mesial Temporal Sclerosis. I called his nurse and she said my problem was something I was born with. I'm assuming she meant genetic which I would have either inherited or caused by some genetic variations which I think are rare. My parents didn't have epilepsy and I don't know that there was anyone in my family who had them. I always thought my seizures were caused by a fall I had as a young child which I guess is why the MRI showed scar tissue. I had another MRI last fall with the same results and that doctor said my seizures were due to the fall I had. How can a doctor make the determination my cause is genetic if all he has is an MRI? Don't they need to do genetic testing? I'll wait to see what he says.

I did have a febrile seizure as a child with chicken pox but my seizures didn't start until the age of 26.