Twins have a high frequency of adverse perinatal events and have been
reported to have an increased risk of seizures. Contrary to popular be
lief, a recent study reported that twins do not have an increased risk
of seizures. We studied the relationship of twinning and epilepsy in
India. The frequency of twinning in families of probands with epilepsy
was compared with the frequency of twinning among hospital births in
the same region of India. We also compared consecutively ascertained p
robands with epilepsy for their twin status and the occurrence of epil
epsies in their twin and non-twin relatives. The frequency of twin bir
ths in families of 524 probands with epilepsy was comparable to the tw
in births among consecutive deliveries over a 3-year period in another
government hospital in the same catchment area (1:99 vs. 1:75). Every
1 in 58 of probands with epilepsy was a twin while a twin was born in
these families every 1 in 71 live births. The frequency of epilepsy i
n non-proband twin relatives was 1.5% compared with 2% among non-proba
nd, non-twin relatives. This data suggests that twin birth is not a ma
jor risk factor for seizures even in families of Indian probands with
epilepsy. Family data such as ours can be used to study the contributi
on by genetic factors in the pathogenesis of complex genetic diseases
such as human epilepsies.