Abstract
We generally agree with the caveats of Dr Bader and Dr French regarding the use of anticonvulsant prescription rates in estimating the prevalence of seizure disorders among prisoners. In some institutions there is a tendency for prisoners to be overmedicated. At one maximum-security institution cited and discussed in our article, 6% of the population were using prescribed anticonvulsants. At three other institutions of similar size, there was close agreement between the rates (1.7%, 1.8%, and 1.9%) of anticonvulsants prescribed. These latter rates are in close agreement with the 1.8% rate of epilepsy by physician diagnoses in studies of the North Carolina prisons and New York City jails. 1,2 We agree that prison physicians are careful to avoid a false-negative error in the treatment of seizure disorders. Unfortunately, in many prisons and jails adequate specialized diagnostic and consultative resources are not readily accessible. Thus, it is possible that false-positive
Published Version
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