Trends in epilepsy mortality in England and Wales and the United States, 1950-1994

The aim of this study was to analyze time trends in epilepsy mortality in E ngland and Wales and the United States between 1950 and 1994. The authors c alculated age- and sex-specific epilepsy mortality rates for the nine quinq uennia from 1950-1954 to 1990-1994. Mortality rates were modeled as a funct ion of age, period of death, and cohort of birth by using Poisson regressio n techniques. From 1950 to 1994, there were more than 110,000 deaths from e pilepsy in the two countries. The secular trends in mortality were similar for both sexes and in both countries. Among people younger than age 20 year s, epilepsy mortality declined steeply after 1950. For young and middle-age d adults, the rate of decline was lower. In the geriatric population, morta lity declined between 1950 and 1974 but then increased. The Poisson model s howed pronounced birth cohort effects. In the United States, epilepsy morta lity fell with each successive birth cohort after 1905. In England and Wale s, there was a similar decline in birth cohort mortality after 1905 for wom en but not until after 1950 for men. The pronounced birth cohort effect sup ports explanations that focus on antenatal and developmental factors as the cause for the decline in epilepsy mortality in ail but the oldest age grou ps between 1950 and 1994.