Nineteen probands with benign epilepsy of childhood and centrotemporal EEG foci (rolandic discharges), 36 of their full parents, and 34 full siblings were included in a genetic study. In these sibships (excluding probands), 15% (5/34) had seizures and rolandic discharges, and 19% (6/32) had rolandic discharges alone. Of the full parents, 11% (5/38) had seizures in chilhood but none in adult life. Only 1 parent (3%) of 36 had rolandic discharges. There was no differnence with sex. The results were tested against different genetic hypotheses and indicate that an autosomal dominant gene with age-dependent penetrance is responsible for the EEG trait.

During a 20-month period, an attempt was made to find all children with unprovoked non-febrile seizures. The first attendance and incidence rates were 95 and 89/100,000, respectively, in the age group 0-15 years. These figures are lower than those found 10 years earlier in the same area. The highest incidence was during the first year of life and there was a higher proportion of girls (male:female ratio 1:1.4). Generalized seizures dominated in the first year of life. The incidence of benign childhood epilepsy with centro-temporal spikes was 10.7/100,000 and was the most common epilepsy syndrome found. The incidence of partial seizures increased with age up to the age of 10 years. One in 10 children had a history of febrile convulsions.

We present 100 children diagnosed with epilepsy who were seizure-free for more than 1 year and still on monotherapy of antiepileptic drugs (AEDs). We matched each child with a healthy classmate and performed neuropsychological testing and EEG before and after complete withdrawal of the AEDs. The withdrawal phase lasted 3 months, but the dose decrease was individualized for each patient. Three to 4 months after complete withdrawal of the drug all patients were reassessed. Patients with seizure relapse are excluded from the study. Seventeen patients are regarded as dropout, 11 because of seizure relapse and six because of protocol violation. The remaining 83 patients were treated with carbamazepine (n = 56), valproic acid (n = 17), or phenytoin (n = 10). Serum concentrations of the AEDs were measured using peak plasma levels that were taken immediately before or after psychological testing. We used neuropsychological tests to assess psychomotor function and "central" cognitive processing such as information processing or memory function. We found significant improvement attributable to drug withdrawal on only one of the cognitive tests, namely, psychomotor speed, suggesting that the impact of AED treatment on higher-order cognitive function is rather limited. In addition, we found group differences between the epilepsy group and the control group at baseline that persisted after drug withdrawal. Subsequent analysis showed some factors that may have contributed to these group differences. First, patients with a former diagnosis of absence seizures show lower scores both at baseline and after drug withdrawal. We may assume that the seizure propensity has not disappeared completely in these patients. Some evidence is found that phenytoin may have a different cognitive profile than carbamazepine, with more impairment on tests that measure motor and mental speed. Again, this impairment persists after drug withdrawal.

Between 1986 and 1988 a door-to-door survey was conducted on a stable rural population of 60,820 in central Ethiopia. Trained lay health workers made a complete census and identified cases with symptoms -and signs of neurological disorders, using specially designed questionnaires which, in a previous pilot study, were found to have a sensitivity of 91% and specificity of 85%. Neurological disorders in the rural population were epilepsy, postpoliomyelitis paralysis, mental retardation, peripheral neuropathy (mainly due to leprosy), and deaf-mutism with prevalence rates (cases/100,000 population) of 520, 240, 170,150 and 130, respectively. The prevalence rates of the other less common neurological disorders were 62 for hemiparesis (15 of which were for cerebrovascular accidents), 20 for cerebral palsy, 16 for optic atrophy, 12 for perceptive deafness, 10 for tropical spastic paraparesis, 7 for Parkinson''s disease and 5 for motor neuron disease, ataxia and chorea/athetosis. Among related non-neurological conditions, blindness, locomotor disability and deafness were predominant. The significance and role of such a neuroepidemiological study in laying the strategies for the prevention of neurological disorders and rehabilitation of patients are discussed in the context of a developing country.

Summary A prospective epidemiological study of the incidence of epilepsy was performed in a Swedish county. The population studied during the incidence period consisted of 52,252 children âged 0–15 years. Seventy‐four children who had had their first seizure during the period February 1, 1973‐January 31, 1974 were reexamined 3 years later. Forty‐three children were classified as having epilepsy at the follow‐up, which gives an incidence of 82/100,000. The most frequent types of epilepsy found were: primary generalized epilepsy, 12/43 (27.9%); partial epilepsies, 11/43 (25.6%); and benign epilepsy of childhood with cen‐trotemporal discharges, 11/43 (25.6%). The prognostic significance of the initial EEG findings in the group with primary generalized epilepsy was low: no differences were found between the number of children who had further seizures and the number of children who had one seizure only. On the basis of clinical and EEG findings some groups tended to run a greater risk of developing recurrent seizures than others. These risk groups were children with perinatal complications or cerebral malformations and psychomotor retardation, children with partial seizures, children with absences and 3/sec spike‐and‐wave discharges, and children with benign epilepsy of childhood. RÉSUMÉ Une étude épidémiologique prospective sur l'incidence de l'épilepsie a été effectude dans un comte suódois. La population etudide durant la periode d'incidence correspondait a 52,252 enfants âgés de 0 a 15 ans. Soixante quatorze enfants ayant presents leur premiere crise durant la periode allant du ler fevrier 1973 au 31 Janvier 1974 ont été réexaminés trois ans plus tard. Quarante trois enfants ont alors pu être considered comme épileptiques ce qui donne une incidence de 82/100,000. Les types les plus frequents d'épilepsie rencontres ont été: 12 cas sur 43 (27.9%) d' épilepsie généralisée primaire, 11 cas sur 43 (25.6%) d'epilepsies partielles, et 11 cas sur 43 (25.6%) d'épilepsie bénigne de l'enfance avec decharges centro‐temporales. La signification pronostique des donnees EEG initiales dans le groupe des enfants avec epilepsie gendralisee primaire s'est averse mediocre: il n'y a pas de difference entre le nombre d'enfants qui ont eu d'autres crises par la suite et le nombre de ceux qui n'ont eu qu'une seule crise. En se basant sur des donnóes cliniques et EEG, il est apparu que certains groupes d'enfants presentaient plus de risques de voir leurs crises se rep^ter. II s'agissait des enfants ayant eu des complications perinatales ou avec malformations cerebrales et retard psychomoteur, des enfants avec crises partielles, de ceux avec absences et ddcharges de pointe‐ondes a 3/sec, et de ceux avec une Epilepsie bónigne de l'enfance. RESUMEN En un condado sueco se ha realizado un estudio epidemiológico prospectivo de la incidencia de la epilepsia. La población estudiada durante el periodo de incidencia consistié en 52,252 ninos êntre 0 y 15 anos de edad. Setenta y cuatro ninos que tuvieron su primer ataque entre el 1 de Febrero de 197...