An epidemiological study of epilepsy and epileptic seizures in two rural Guatemalan communities

A cross-sectional epidemiological study of two communities in Guatemala, El Jocote and Quesada, was conducted to determine the prevalence of epilepsy and epileptic seizures. An initial screening questionnaire was applied to d etect individuals who had possibly suffered seizures in the past. These ind ividuals were then examined more thoroughly by a neurologist, to confirm or reject them as cases of epilepsy. The crude prevalences of epilepsy so rev ealed were 28 cases/1000 in El Jocote and 29 cases/1000 in Quesada. The pre valence of active epilepsy in each community was approximately 18 cases/tho usand. The most common type of seizure suffered was of the generalised toni c-clonic type. Seventy-six of the individuals who had a history of epilepti c seizures and 51 individuals from the same communities with no such histor y were then given brain scans, using computerized axial tomography. These n euro-imaging studies revealed some form of abnormal image in 33% (17) of th e subjects with no history of seizures and 70% (53) of those with a history of seizures (chi (2) = 12. 2; P < 0.00006). The frequency of detected brai n abnormalities in the individuals who had suffered a single episode of sei zures was similar to that in those who were classified as epileptic. The mo st commonly observed type of abnormality was punctate calcification, follow ed by cerebral oedema and hypodensities. The reasons for the high prevalenc es of epilepsy, epileptic seizures and abnormal neuro-images observed in th e present study merit further investigation. Although neurocysticercosis ca used by Taenia solium was thought to be a significant cause of the epilepsy occurring in the study communities, many apparently non-epileptic individu als have brain lesions indicative of this disease.