Prevalence and Clinical Features of Epilepsy in a Biracial United States Population

Abstract

A need for prevalence information emphasizing racial differences prompted a door-to-door survey of all residents of Copiah County, Mississippi. The fieldwork involved a complete census and an extensive screening questionnaire inquiring about diagnoses, signs, and symptoms of neurologic disease. Residents who lived in institutions or had screening responses suggestive of epilepsy were requested to have an examination by neurologists who used defined diagnostic criteria. Prevalence day was 1 January 1978, and the survey yielded prevalence ratios of 1,043/100,000 inhabitants for epilepsy and 678/100,000 inhabitants for active epilepsy. Age-adjusted prevalence ratios were somewhat higher for males and for blacks. Of the 246 identified cases of epilepsy, 37% were judged symptomatic. The leading (putative) cause was head trauma, especially among white males. About 57% of the 246 cases had been evaluated previously by a neurologist or neurosurgeon, while 7% had never been evaluated medically before the survey.

Comparative Epidemiology of Epilepsy in Pakistan and Turkey: Population‐Based Studies Using Identical Protocols

“…The frequency of CPS in the present study (6% in Pakistan and 12.3% in Turkey) was low, but similar figures have been reported in several surveys: 6% in Copiah County, Mississippi (14); 6% in a Parsi community in Bombay (24); and 2.8% in China (16). A higher frequency of 14.6% in a population aged >15 years in Libya (15) may have resulted from a selection bias.…”

“…In the present survey, 38.4% of cases in Pakistan were determined to be symptomatic, as compared with 35.7% of cases in Turkey. Estimates of symptomatic cases in other studies vary: 17.5% in Libya (15); 21% in China (16); 23.3% in Rochester, Minnesota (21); 25% in England (28); and 37% in Copiah County, Mississippi (14).…”

“…In the present study, epilepsy was marginally more prevalent in women in Pakistan, but in Turkey its prevalence was slightly higher among men (neither finding was statistically significant) (Table 4). A slightly higher prevalence among men has been reported in Rochester, Minnesota (21); Copiah County, Mississippi (14); Tokyo (22); and Copparo, Italy (3). On the whole, the variations in the male/ female ratio are minimal and probably insignificant.…”

“…An important constituent of ILAE classification, EEG data, is difficult to establish in developed countries (14,21) and is even more difficult in countries like Pakistan and Turkey. A notable exception is a study conducted in China (16).…”

“…Similar problems were encountered in Kashmir, India (17), where 9.5% of cases remained unclassifiable. In a study in Copiah County, Mississippi (14), seizures were classified as "definite," "probable," and "possible," which illustrates the problems of seizure classification.…”