EPILEPSY IN PAKISTAN - A POPULATION-BASED EPIDEMIOLOGIC-STUDY

A house-to-house, cross-sectional, population study of epilepsy on 24, 130 individuals of all ages from southern Pakistan indicates an age-sp ecific prevalence rate of 9.99 in 1,000 (14.8 in 1,000 in rural and 7. 4 in 1,000 in urban areas) for recurrent, nonfebrile ''active'' epilep sy in Pakistan. Mean onset of epilepsy was 13.3 years, and 74.3% epile ptic persons were aged <19 years at onset of the disorder. The most co mmon seizure type was tonicclonic in 77% [primary generalized tonic-cl onic (GTC) in 59% and secondarily generalized in 18%], simple partial (SPS) in 5%, complex partial (CPS) in 6%, generalized absence in 1%, t onic in 3%, and myoclonic in 3% cases. Multiple seizure types in the s ame person were evident in 9.6% of only the generalized group. A putat ive cause could be suggested in 38.4% of cases: 32% had a positive fam ily history of epilepsy, most common among siblings. Common perceived precipitants included fever in 29.2% and emotional disturbances in 16. 6%. Only 3% of epileptic persons believed that their illness was due t o supernatural causes. Treatment status was very poor, with only 2% ru ral and 27% urban epileptic persons receiving antiepileptic drugs (AED s) at the time of the survey. We discuss the logistic and management p roblems of population-based epidemiologic studies in developing countr ies.