EPIMART: Prospective incidence study of epileptic seizures in newly referred patients in a French Carribean island (Martinique)

Purpose: To identify, in the population living in the island of Martinique, persons who had their first epileptic seizure or first came to medical att ention because of an epileptic seizure. Methods: Between May 1, 1994, and April 30, 1995, we collected all suspecte d cases of provoked and unprovoked epileptic seizures admitted to the hospi tals or addressed to the private neurologists or pediatricians of the islan d. Results: Three hundred nine cases were collected. Rate of initial diagnosis of provoked and nonprovoked seizures (standardized to the U.S. population) : 77.7/100,000, with a bimodal distribution of the cases with age (86 in 0- to 10-year age group and 203 in patients older than 60 years). Sixty-three cases were classified as provoked seizures (incidence, 16.4/100,000). Alco hol consumption, stroke, and cranial trauma were the most frequent causes ( 30.1, 20.6, and 18.7%, respectively). Two hundred forty-six cases were clas sified as unprovoked seizures (incidence, 64.1): seizures with a stable con dition, 74 cases (I, 19.3); seizures with an evolutive condition, 17 cases (I, 4.5); seizures of unknown etiology, 155 cases (I, 40.4). These figures must be considered as the minimal rate. Conclusions: The global incidence rate of newly referred persons with a dia gnosis of epileptic seizures in this study is clearly higher than those obs erved in industrialized countries but lower than those in developing countr ies. The major risk factors are represented by alcohol consumption, followe d by stroke, cranial trauma, and infectious diseases.