EPILEPSY IN A POPULATION OF 6000 REEXAMINED - SECULAR TRENDS IN FIRSTATTENDANCE RATES, PREVALENCE, AND PROGNOSIS

It is important to document changes in the vital statistics of epileps y in the general population so that the success or failure of preventi on and treatment can be assessed and health provisions planned. A popu lation of 6000 persons was studied 10 years apart to determine secular trends in the prevalence and prognosis of epilepsy. The lifetime prev alence of all patients with one or more afebrile seizures was 20.3/100 0 (95% CI 16.9-24.3) in 1983 and 21.0/1000 (95% CI 17.6-25.1) in 1993. The prevalence of active epilepsy was 5.3/1000 (95% CI 3.6-7.5) in 19 83 and 4.3 (95% CI 2.8-6.3) in 1993. To assess trends in incidence rat es the annual first attendance rates were measured from 1964 to 1993. Annual first attendance rates in children (age < 20 years) have declin ed from 152.4/100 000 (90% CI 106.0-212.9) in the years 1974-83, to 60 .9/100 000 (90% CI 33.0-103.3) in the years from 1984-93, suggesting t hat the incidence of epilepsy in children is falling, Also noteworthy was the first attendance rates for epilepsy in elderly people (61-80 y ears) in the years 1984-93, of 82.0 (90% CI 38.5-154.0), higher than i n any other age group. This increase in the number of elderly patients with epilepsy is important, and has health planning implications, esp ecially with the overall increase in the total elderly population. The re was, however, no evidence that prognosis has significantly altered in the past 40 years.