Prevalence of epilepsy in Okayama Prefecture: a neuroepidemiologic study

On the prevalence day, 2,378 epileptic children were identified. Therefore, the prevalence rate for epilepsy was 8.2 per 1,000. The lowest prevalence rate was 1.2 in children under one year of age, and the highest was 11.0 at five years of age. The rate was higher for males than females. The annual incidence rate for epilepsy was estimated at 145.0 per 100,000 for 1975. The onset of seizures was high in the first three years, totaling 1,795 cases (77.7%), and this decreased after four years of age. Primary generalized epilepsy was found in 577 cases (31.7%), secondary generalized epilepsy in 167 (9.2%), partial epilepsy with elementary symptomatology in 205 (11.3%), with complex symptomatology in 61 (3.3%) and partial seizures secondarily generalized in 801 (44.5%). The study on such a number of cases had hitherto never been reported in the world.     

Prevalence of Epilepsy in Okayama Prefecture: A Neuroepidemiologic Study

• 1 On the prevalence day, 2,378 epileptic children were identified. Therefore, the prevalence rate for epilepsy was 8.2 per 1,000. The lowest prevalence rate was 1.2 in children under one year of age, and the highest was 11.0 at five years of age. The rate was higher for males than females.
• 2 The annual incidence rate for epilepsy was estimated at 145.0 per 100,000 for 1975.
• 3 The onset of seizures was high in the first three years, totaling 1,795 cases (77.7%), and this decreased after four years of age.
• 4 Primary generalized epilepsy was found in 577 cases (31.7%), secondary generalized epilepsy in 167 (9.2%), partial epilepsy with elementary symptomatology in 205 (11.3%), with complex symptomatology in 61 (3.3%) and partial seizures secondarily generalized in 801 (44.5%).
• 5 The study on such a number of cases had hitherto never been reported in the world.

     

Prevalence of active epilepsy in a rural area in South Tanzania: a door-to-door survey

Summary:  Objective: A door-to-door survey was carried out to assess the prevalence of active epilepsy in the rural population within the catchment area of the Mnero Diocesan Hospital in Southern Tanzania.
Methods: A total of 4,905 individuals living in 1,047 households were enrolled in a study, consisting of a screening dialogue with a representative family member followed by a face-to-face interview with the affected subject. The diagnosis of epilepsy followed clinical guidelines proposed by the International League Against Epilepsy (ILAE).
Results: We detected 42 cases (21 males and 21 females) of active epilepsy (8.6/1,000; 95% CI: 6.0/1,000–11.1/1,000; age-adjusted prevalence ratio: 7.4/1,000). Thirty of them met the case definitions of generalized seizures, whereas 12 patients reported partial seizures. The peak prevalence was found in both sexes in the second decade of life (f: 16.9/1,000; m: 15.8/1,000; t: 16.4/1,000), with a second peak in the group aged 30–39 years (f: 10.4/1,000; m: 8.8/1,000; t: 9.7/1,000). Eleven patients (26.2%) were classified as "strongly suspected of symptomatic" epilepsy, the remaining 31 patients (73.8%) as possibly being idiopathic, symptomatic, or cryptogenic epilepsy cases.
Discussion: This study provides baseline data about the active epilepsy prevalence in a rural African population. Compared to western countries, our study confirmed a pattern toward higher prevalence of epilepsy in tropical countries. As shown in previous studies, we observed a higher prevalence of epilepsy in children and adolescents, followed by a steady decline with increasing age. Reasons for this type of frequency could be ascribed to malnutrition, trauma, genetic conditions, antenatal and prenatal care, diseases resulting in febrile convulsions, cerebral infections and may even result in death in specifically diseased individuals.     

The prevalence of epilepsy and pharmacoresistant epilepsy in adults: a population-based study in a Western European country

Purpose: To determine the prevalence of epilepsy in a defined adult population and identify the frequency and principal features of pharmacoresistant epilepsy.
Methods: From a population over 15 years of age residing in a medium-sized French city, all patients with epilepsy on June 30, 1995 were identified from multiple sources. Pharmacoresistance was defined as failure to control epilepsy by at least two first-line antiepileptic drugs, with a seizure frequency of at least one per month for 18 months. Collected data were examined by experts in epileptology, and responding patients were reexamined using a standardized diagnostic questionnaire. ILAE definitions and classifications were used.
Results: The age-adjusted prevalence of active epilepsy was 5.4 per 1,000 (95% CI: 4.7–6.0) and was higher for males (7.8) than for females (5.2). For epilepsy in remission under treatment, this rate was 0.7 per 1,000 (95% CI: 0.5–0.95). Age-specific prevalence was highest in age groups 25–49 years and declined in the oldest age groups. Localization-related seizures represented 61.1% of cases and generalized seizures 30.9%. The proportion of noncontrolled epilepsy (seizure-frequency at least one per month for 18 months) was 15.6%, corresponding to a prevalence of 0.94 per 1,000. In this group, the mean age at onset was lower (p = 0.0007) and localization-related epilepsy more frequent (p = 0.01).
Conclusion: The findings support previous epidemiological estimates of the prevalence of epilepsy in developed countries. For approximately one patient in eight, epilepsy was not adequately controlled.     

First-ever, door-to-door cross-sectional representative study in Prey Veng province (Cambodia)

Purpose: To estimate the lifetime prevalence of epilepsy in Prey Veng province (Cambodia). Methods: Door‐to‐door screening was performed using a random cluster survey whereby all people >1 year of age were screened for epilepsy by using a validated and standardized questionnaire for epilepsy in tropical countries. Suspected epilepsy patients identified by the questionnaire were revisited and examined by epileptologists. The confirmation of epilepsy was based on an in‐depth clinical examination. Electroencephalograms were recorded at the community dispensary. Key Findings: Five hundred three potential epilepsy cases were identified from 16,510 screened subjects, and 96 were diagnosed to have epilepsy. An overall prevalence of 5.8 per 1,000 [95% confidence interval (CI) 4.6–7.0 per 1,000] was obtained. Generalized epilepsy (76%) was more common than partial epilepsy (12.5%). Three cases were of generalized myoclonic epilepsy (3.1%) and one case each (1.0%) were of absence and olfactory partial epilepsy. Six cases (5.2%) had more than one seizure type [one case with absence + generalized tonic–clonic (GTC), one case each with GTC + partial seizures with secondary generalization and absence + generalized myoclonic seizures and absence + simple partial seizures, and two cases with GTC + complex partial seizures]. Electroencephalography (EEG) studies revealed spike and wave discharges in 43.8%, focal spikes in 21.0%, generalized slow waves in 19.2%, and generalized slowing of background in 15.7%. Significance: This is the first population‐based study in Cambodia that had epilepsy as a primary objective, and compared to Western and neighboring countries it shows a lower prevalence.     

Prevalence and clinical features of epilepsy in Argentina. A community-based study

OBJECTIVE: To ascertain the prevalence of epilepsy in Junín, a town of 70,000-80,000 inhabitants from the Province of Buenos Aires, Argentina. BACKGROUND: Some South American communities have reported extremely high prevalences of epilepsy. We investigated whether Junín would also have a high prevalence. DESIGN/METHODS: Systematic sampling was used to select 5,839 households (sampling fraction = 25%). Participating households amounted to 5,648 (97%), with 17,049 persons. A two-phase case-finding strategy was used. Phase 1 was the screening of the 17,049 persons, which was performed by trained but medically unsophisticated interviewers. Phase 2 was the neurological evaluation of the 250 persons who were screened positive for epilepsy. Diagnoses were based on defined diagnostic criteria. RESULTS: As of January 1, 1991 (prevalence day), 106 persons had epilepsy, including 64 (60%) with active epilepsy. Among these, 9 (14%) were epilepsy cases newly diagnosed by survey neurologists, and 50 (78%) were on antiepileptic treatment at the time of the survey. Regarding the same 64 persons, seizures were generalized in 37 (58%) and partial in 24 (38%). Lifetime prevalence of epilepsy was 6.2/1,000 (6.3/1,000, age adjusted to the world standard population). Total point prevalence for active epilepsy was 3.8/1,000 (4.0 for females and 3.5 for males). In addition, prevalence peaked at the ages of 40-59 for females and 0-4 for males. CONCLUSIONS: This is one of the first community-based studies of epilepsy in Argentina, and the prevalence results provide new epidemiological data contributing to our understanding of the different prevalence rates found in Latin America.     

Epilepsy in Colombia: epidemiologic profile and classification of epileptic seizures and syndromes

PURPOSE: A national study was performed in Colombia to determine the general and regional prevalence of epilepsy, clinical profiles, seizure types, and clinical syndromes. METHODS: Based on the National Epidemiological Study of Neurological Diseases (EPINEURO), we evaluated and followed up for 1 year all the subjects with epilepsy from the National Sample. Clinical profiles were further assessed. Seizure types and epilepsy syndromes were established according to the international classifications. RESULTS: General prevalence was found to be 11.3 per 1,000, with little variation among regions, except the eastern region, where prevalence was 23 per 1,000; prevalence for active epilepsy was 10.1 per 1,000. Women have a slightly greater (not statistically significant) risk. Most seizures are focal (partial), frequently with secondary generalization. The most frequent epilepsy syndrome encountered was partial symptomatic/cryptogenic (80%). Epilepsy onset in Colombia occurs most frequently in childhood. CONCLUSIONS: Prevalence rates of epilepsy in Colombia are similar to those reported in nations with comparable developmental status and have diminished over time. The study presents the distribution of seizures and syndromes. The most frequent types are focal syndromes.     

Epidemiologic Study of Epilepsy in Young Singaporean Men

PURPOSE: This survey of 20,542 Singaporean men born in 1974 studied the clinical features of young men diagnosed with epilepsy on preenlistment screening. METHODS: All male citizens in Singapore are medically screened at age 18 years before enlistment for compulsory military service. Patients suspected to have epilepsy are then referred to government hospitals for further management. We interviewed the patients and their parents and reviewed their hospital records. RESULTS: Eighty-nine patients with epilepsy were identified, indicating a lifetime prevalence of 4.9/1,000 males by age 18 years. The lifetime prevalence of epilepsy among Chinese, Malays, and Indians were 5.2, 2.8, and 6.4/1,000, respectively; these differences were not statistically significant. The mean age of seizure onset was 11.1 years. Generalized seizures (65.2%) were commoner than partial seizures (34.8%); common seizure types included generalized tonic-clonic seizures (52.8%), complex partial seizures with secondary generalization (24.7%), and myoclonic seizures (5.6%). Common epileptic syndromes included temporal lobe epilepsy (16.9%), juvenile myoclonic epilepsy (5.6%), and frontal lobe epilepsy (2.2%). Eighty-four (94.4%) patients sought medical treatment, and seven (7.9%) patients sought additional traditional treatment. Although 70 (78.7%) patients responded to medication, 14 (15.7%) patients remained refractory to treatment. CONCLUSIONS: The lifetime prevalence of epilepsy in young Singaporean men was 4.9/1,000. The majority (65.2%) had generalized seizures. Temporal lobe epilepsy was the commonest (16.9%) defined epilepsy syndrome. More patients with epilepsy (94.4%) sought medical treatment, although 15.7% remained refractory to medication.     

A systematic review of the epidemiology of epilepsy in Arab countries

In this report the epidemiologic aspects of epilepsy in Arab countries are systematically reviewed. MEDLINE and Embase were searched, and six papers were identified: one incidence report from Qatar and five prevalence reports (two from Sudan, and one from each of Libya, Tunisia, and Saudi Arabia). An incidence of 174 per 100,000 persons in 2001 was reported in a hospital-based study from Qatar. Prevalence ranged between 0.9/1,000 in Sudan and 6.5/1,000 in Saudi Arabia, with a median of 2.3/1,000. An approximate 724,500 people with epilepsy live in the Arab world. All the studies report higher prevalence in males, which was statistically significant in the Saudi study. The prevalence is approximately 2-fold higher in children and young adults, compared to the rates in middle age. Two studies showed a high prevalence in individuals older than 60 years of age. Primary generalized seizures are reported in 28–97% of cases, partial seizures in 3–43.8%, and unclassified seizures in 18–51%. Idiopathic epilepsy represents 73.5–82.6% of cases. Early childhood brain damage such as in cerebral palsy and mental retardation represented a major cause of symptomatic epilepsy, whereas infection was the main cause in Sudan. The epidemiologic data from Arab states are lacking, especially from populous countries like Egypt, Algeria, and Syria. Well-designed studies are needed to accurately determine the burden of epilepsy in the Arab world.