Epidemiology Of Epilepsy Research Articles

Impact of annual community-directed treatment with ivermectin on the incidence of epilepsy in Mvolo, a two-year prospective study.

The potential impact of cumulative community-directed treatment with ivermectin (CDTI) on epilepsy epidemiology in Mvolo County, South Sudan, an onchocerciasis-endemic area with high epilepsy prevalence, was investigated. Annual CDTI was introduced in 2002 in Mvolo, with interruptions in 2016 and 2020. Comprehensive house-to-house surveys in Mvolo (June 2020 and 2022) identified cases of epilepsy, including probable nodding syndrome (pNS). Community workers screened households in selected sites for suspected epilepsy, and medical doctors confirmed the diagnosis and determined the year of seizure onset. The incidence of epilepsy, including pNS, was analysed using 95% confidence intervals (CIs). Data on ivermectin intake and onchocerciasis-associated manifestations (itching and blindness) were collected. The surveys covered 15,755 (2020) and 15,092 (2022) individuals, identifying 809 (5.2%, 95% CI: 4.8-5.5%) and 672 (4.5%, 95% CI: 4.1-4.8%) epilepsy cases, respectively. Each survey reported that a third of the surveyed population experienced skin itching, and 3% were blind. Epilepsy incidence per 100,000 person-years gradually declined, from 326.5 (95% CI: 266.8-399.1) in 2013-2015 to 96.6 (95% CI: 65.5-141.7) in 2019-2021. Similarly, pNS incidence per 100,000 person-years decreased from 151.7 (95% CI: 112.7-203.4) to 27.0 (95% CI: 12.5-55.5). Coverage of CDTI was suboptimal, reaching only 64.0% of participants in 2019 and falling to 24.1% in 2021 following an interruption in 2020 due to COVID-19 restrictions. Additionally, while 99.4% of cases had active epilepsy in 2022, less than a quarter of these had access to antiseizure medication. The observed decrease in epilepsy incidence despite suboptimal CDTI coverage highlights the potential impact of onchocerciasis control efforts and underscores the need to strengthen these efforts in Mvolo County and across South Sudan. As a proactive measure, Mvolo and neighbouring counties are transitioning to biannual CDTI. Furthermore, the substantial epilepsy treatment gap in Mvolo should be addressed.

Epidemiology of epilepsy in old age – English Version

Epidemiology of epilepsy in old age – English Version

Epidemiology of Epilepsy in Fayoum Governorate, Egypt: A Community-based Study

Epidemiology of Epilepsy in Fayoum Governorate, Egypt: A Community-based Study

Epidemiology of Epilepsy in Low- and Middle-Income Countries: Experience of a Standardized Questionnaire over the Past Two Decades

Introduction: Epilepsy affects >50 million people worldwide, with 80% of them living in low- and middle-income countries (LMICs). Studies with a standardized methodology are required to obtain comparable data on epilepsy and implement health policies in order to reduce the treatment gap and improve the diagnosis and management of epilepsy. In 2000, following the guidelines of the International League Against Epilepsy (ILAE), the “questionnaire for investigation of epilepsy in tropical countries” (IENT questionnaire) was developed to promote epidemiological surveys on epilepsy using a standard methodology. This study aims to describe how, when, where, and why the IENT questionnaire has been used through epidemiological studies on epilepsy over the last 2 decades and to acquire users’ opinions about the tool. Methods: Studies that used the IENT questionnaire were searched through international and local bibliographic databases, including the gray literature. An online survey was carried out, including a snowball effect. Original research studies were included. Characteristics of the studies and populations and general information on the instrument and its use were collected. Results: Eighty-two documents were selected referring to 61 studies that were mostly carried out on the African continent (n = 54). Most of them aimed to determine the prevalence (n = 31) and associated factors (n = 28) of epilepsy in LMICs. Among the 61 studies, 35 were population-based, and 30 included both adults and children. A methodological heterogeneity was found between studies, and in cases where the IENT questionnaire alone did not ensure complete data collection, other tools were used concomitantly (n = 40). Discussion/Conclusion: Over the last 2 decades, the IENT questionnaire has been continuously used in different LMICs. This result favors its promotion and updating, with the inclusion of new topics related to epilepsy (e.g., comorbidities, quality of life, and stigma), current ILAE guidelines, and digital versions.

Epilepsy lifetime prevalence in Iran: a large population- based national survey

Epilepsy has garnered increased public health focus because patients who suffer from epilepsy experience pronounced and persistent health and socioeconomic disparities despite treatment and care advances. The epidemiology of epilepsy is diverse in different countries and regions. This nationwide population-based cross-sectional study was conducted to determine the life time prevalence and health related factors of epilepsy for the first time in Iran through a two-phase door-to-door survey method. In phase I, a screening for epilepsy was performed on 68,035 people. Then in phase II, after the neurological evaluation of participants and reviewing medical records, 1130 subjects with epilepsy was confirmed. The life time prevalence of epilepsy was achieved to be 16.6 per 1000 people (95% CI 15.4–17.8) with the average age onset 19.1 ± 21.1 (active prevalence 9.5 per 1000 people). Focal seizure (59.3%), generalized epilepsy (38%) and unknown types of epilepsy (2.7%) were detected among participants. The overall life time prevalence of febrile convulsion was 4.1 per 1000 people. The frequency of attacks per year and per month were 3.0 ± 1.6 and 0.5 ± 0.1, respectively. Age-specific life time prevalence was highest among the age group of 15–19 years old [32.7 per 1000 persons (95% CI 29.1–36.8)] and it was higher in male (53.8%) than female (46.2%) participants. Our results showed that the life time prevalence of epilepsy in Iran is higher than worldwide average.

Results of the expert forum on the use of perampanel in adolescents with epilepsy in everyday clinical practice

In June 2020, an online forum of experts on the use of perampanel in adolescents with epilepsy in everyday clinical practice was held. The main goal was to discuss the features of juvenile epilepsy, its diagnosis, the possibilities of using perampanel in this category of patients, and the effectiveness of using the drug in everyday clinical practice. The forum was attended by leading experts in neurology and epileptology. Current data on the epidemiology of epilepsy in the child and juvenile population were presented; the issues of difficulties and diagnostic errors were considered, as well as features of managing adolescents with epilepsy, adverse events of antiepileptic therapy, results of studies on the effectiveness of perampanel, and many social aspects of the life of patients in this category.

Epilepsy-Definition, Classification, Pathophysiology, and Epidemiology.

Seizures affect the lives of 10% of the global population and result in epilepsy in 1 to 2% of people around the world. Current knowledge about etiology, diagnosis, and treatments for epilepsy is constantly evolving. As more is learned, appropriate and updated definitions and classification systems for seizures and epilepsy are of the utmost importance. Without proper definitions and classification, many individuals will be improperly diagnosed and incorrectly treated. It is also essential for research purposes to have proper definitions, so that appropriate populations can be identified and studied. Imprecise definitions, failure to use accepted terminology, or inappropriate use of terminology hamper our ability to study and advance the field of epilepsy. This article begins by discussing the pathophysiology and epidemiology of epilepsy, and then covers the accepted contemporary definitions and classifications of seizures and epilepsies.

Epidemiology of Epilepsy in Lubumbashi, Democratic Republic of Congo.

Background Epilepsy is one of the most common neurological conditions, but the majority of epilepsy patients in sub-Saharan countries do not receive appropriate treatment. In the Democratic Republic of Congo (DRC), particularly in Lubumbashi, very few epidemiological studies on epilepsy have emerged. This study aims to analyze demographic characteristics, semiology of epileptic seizures, and their etiologies in patients followed in hospital. Methods This is a prospective descriptive study that enrolled 177 epileptic patients who performed a neurological consultation at the Centre Médical du Centre Ville (CMDC) in Lubumbashi (DRC) from January 1, 2016, to December 31, 2017. Results The mean age of the patients was 20.0 years (range: 5 months and 86 years). The male sex was predominant (57.1%). The mean age at the seizure onset was 13.1 years, and the mean duration between onset of seizures and consultation was 83.5 months. The family history of epilepsy was present in 27.7%. Generalized tonic-clonic seizures were the most frequent (58.2%), followed by atonic generalized seizures (9.6%) and focal clonic seizures (8.5%). The etiology was found in 68 (38.4%) patients and was dominated by neurocysticercosis (26.5%), meningitis (25%), perinatal pathologies (20.6%), and head injury (20.6%). Conclusion This study is a useful starting point from which health programs and health professionals can work to improve the diagnosis and quality of epilepsy management in our community.

New web-approach epidemiology study of drug-resistant temporal lobe epilepsy (TLE) in Uzbekistan

We reviewed data on the epidemiology of epilepsy in Uzbekistan and estimated the prevalence and incidence of drug-resistant temporal lobe epilepsy (TLE) due to hippocampal sclerosis (HS) based on extrapolation from the available data drawn from the literature. We searched the electronic database PubMed, using the following search terms in the title: “epilepsy” OR “temporal lobe” OR “hippocampal sclerosis” AND “epidemiology” OR “prevalence” OR “incidence.” Relevant original studies were included. We also reviewed several previous systematic reviews, meta-analyses, and their references. We concluded that the estimated current Uzbek prevalence of drug-resistant HS-TLE is 0.47–0.63 cases per 1000 people, and the estimated Uzbek incidence is 2.8–3.0 cases per 100,000 people per year. Based on a Uzbek population of 33 million, we estimate that as many as 13900–17800 Uzbek patients still suffer from drug-resistant HS-TLE and are in need of surgery or other therapeutic options. Although full scale epidemiologic studies on drug-resistant HS-TLE are needed, several observational studies allow adequate estimates of the range for the incidence and prevalence of this condition. Given the morbidity and mortality associated with poorly controlled seizures, this relatively large and growing patient population is a matter of concern. Considering the variety of treatment options that are available or in the pipeline to treat drug-resistant epilepsy, future efforts should focus on advocating for early referral of patients with drug-resistant HS-TLE for more comprehensive epilepsy management.

Long-Term Study about the Incidence of Epilepsy in Male Service Personnel from India: A Retrospective, Cohort Study.

Background The data on the epidemiology of epilepsy are limited for developing countries including India. We estimated the incidence of epilepsy in a cohort of service personnel from India followed for over two decades. Materials and Methods The data for this epidemiological study were derived from the electronic medical records (EMRs) of the male service personnel. The participants (age < 18 years) were enrolled into active service between 1990 and 2015 in good health. The data pertaining to the diagnosis of epilepsy were derived from the EMR using the prevalent International Classification of Diseases codes. We calculated the incidence rate as per person-years (py) using appropriate statistical methods. Results Our data included 51,217 participants (median age: 33 years, range: 17–54) with a mean follow-up of 12.5 years, giving a cumulative follow-up duration of 613,925 py. A total of 291 patients developed epilepsy during the study, giving an incidence rate of 0.47 per 1000 py (95% confidence interval: 0.42–0.53). Undifferentiated spondyloarthropathy, central nervous system disorders, and alcohol dependence syndrome were the common comorbid ailments in patients with epilepsy. Conclusion Our cohort had a comparable incidence rate of epilepsy with other studies from India and abroad.

Epidemiology and familial clustering of pediatric epilepsy in the geographic isolate of Ischia

BackgroundGeographic isolates are the ideal setting to study the genetic background and the epidemiology of epilepsy. There are only few published reports on the epidemiology of pediatric epilepsy in geographic isolates. MethodsThis study was performed in the Ischia island, district of Napoli (Southern Italy). The local population includes 61,086 individuals, 8381 of them aged from 0 to 14 years. We included children with two or more unprovoked seizures or one unprovoked seizure associated to a high risk of relapse, observed from 2004 to 2017. Neonatal, febrile and acute symptomatic seizures were excluded. Eligible patients were identified through the local pediatricians’ medical records. All probands and their parents underwent a face-to-face interview. Clinical charts were reviewed and electroclinical diagnoses were confirmed by two authors (AC, VB). ResultsThirty-six children and adolescents were included. Overall, the prevalence of epilepsy in the Ischia island was 4.3 per 1,000 (95% CI 3.0–5.9). Incidence was 51.7 per 100,000 person-years (95% CI 36.2–71.6). Sixteen (44.4%) patients had a genetic (idiopathic) origin and 20 (55.6%) a symptomatic (structural/metabolic) etiology. Nine probands (25%) had at least one family member with epilepsy (including third-degree relatives). Their pedigrees were suggestive of dominant inheritance in six and of recessive inheritance in three families. ConclusionsThe epidemiological features of pediatric epilepsy in this geographic isolate are similar to the general population. A family history was reported in one fourth of the patients with a wide clinical heterogeneity, likely reflecting genetic heterogeneity in this population.

Excess Mortality in Active Convulsive Epilepsy and Associated Risk Factors in Sub-Saharan Africa

Background: In sub-Saharan Africa, there is a paucity of evidence on the magnitude of excess mortality in epilepsy relative to the general population and risk factors associated to this excess. This study estimated excess mortality in people with active convulsive epilepsy (ACE) using data from the Studies of Epidemiology of Epilepsy in Demographic Surveillance Sites in three sub-Saharan African (SSA) countries. Methods: We followed those with and without epilepsy and documented deaths in Agincourt (South Africa), Ifakara (Tanzania) and Kilifi (Kenya) for duration of seven, six and eight years, respectively. Findings: A total of 199 deaths in ACE and 16,801 in general population were observed from the time of diagnosis to the most recent household survey. Mortality rates in ACE were estimated at 31.5 deaths per 1,000 person-years (95%CI: 19.4-43.6) in Agincourt, 23.9 (95%CI: 11.7-36.1) in Ifakara and 24.6 (95%CI: 19.5-29.6) in Kilifi. Pooled estimates of excess mortality (Standardized mortality ratio (SMR)), was 4.8 (95% CI: 4.2-5.6) times higher in PWE than those without epilepsy. Adjusting for age, SMRs were 3.20 (95%CI: 2.41-4.27) in Agincourt, 4.66 (95%CI: 3.46-6.29) in Ifakara and 6.22 (95%CI: 5.15-7.50) in Kilifi. Interpretation: This study demonstrates evidence of excess mortality in PWE in SSA countries. Mortality burden may be reduced by managing seizures with improved access to antiepileptic drugs, preventive measures against accidents, reducing perinatal adverse events at birth, preventing parasite infections with proper management of domesticated animals and hygiene, empowering PWE with education and decent low-risk jobs and managing co-morbidities. Funding Statement: This work was supported by grants from The Wellcome Trust [Grant No. 083744] to C.R.N.; Ifakara Health Institute under Training Unit and Basel Canton. The Agincourt HDSS is funded by the Wellcome Trust, UK (grants 058893/Z/99/A; 069683/Z/02/Z; 085477/Z/08/Z), with important contributions from the University of the Witwatersrand, the South African Medical Research Council, and the William and Flora Hewlett Foundation, National Institute on Aging (NIA) of the NIH, and Andrew W Mellon Foundation, USA. Declaration of Interests: Authors declare no conflict of Interest. Ethics Approval Statement: The study protocol was approved by Ifakara Health Institution Internal Review Board (IHI/IRB/No. A 70-2009) and National Institute of Health Research and Commission of Science and Technology with reference NIMR/HQ/R.8a/Vol. IX/1256. All participants were enrolled through verbal consent.

Epidemiología de la epilepsia en España y Latinoamérica

The connection between Spain and Latin America on the cultural, ethnic and commercial levels has been very important over the last five centuries, and this accounts for the existence of a common identity that can condition the epidemiology of chronic diseases with genetic and environmental determinants, such as epilepsy. In the last 15 years significant changes have come about in the economic development and the healthcare conditions in these countries as well as the migratory flows among them that may have brought about changes in the previous epidemiological situation. We present an exhaustive review of the epidemiological studies describing the status of epilepsy in Spain and Latin America. A bibliographic search was conducted of descriptive epidemiology studies about epilepsy in Spain and in each of the countries of Latin America. The methodology and quality of each study are reviewed and data on prevalence and incidence are extracted for each country. A total of 796 studies are evaluated, of which 55 (48 on prevalence and seven on incidence) meet eligibility criteria. There is no evidence of a variation in the epidemiological situation of epilepsy in Latin America. Some prevalence and incidence rates are still higher than in western countries. This difference is especially apparent in countries where cysticercosis is endemic and is inversely proportional to the wealth of the country, measured by the per capita gross domestic product. There is no evidence of any change in the epidemiology of epilepsy in Spain despite the migratory flows of countries with a high prevalence of epilepsy in recent years.

9 Retrospective survey of epilepsy and anticonvulsant usage in patients with acquired brain injury (abi) at a national rehabilitation hospital

Objective There is a lack of data with regard to the epidemiology of epilepsy in patients admitted to the NRH. Developing the knowledge base is likely to help inform prescribing practice, risk discussion, education of patients and staff thereby improve care and clarity of communication both to people with epilepsy and those involved in supporting them. This study aimed to gather data on: 1. Epidemiology of seizures/epilepsy relating to in-patients at the 2. NRH, Anticonvulsant prescribing practice Method A proforma was developed identifying key factors pertaining to epilepsy/seizures. This was piloted on 5 cases and amendments made. Discharge letters of all patients with ABI, discharged between 1/1/14–31/12/14 were analysed retrospectively using this proforma and data extracted. Results A total of 279 discharge letters were examined (181M, 98F). 52 patients had a diagnosis of epilepsy at the time of admission. 42 patients (36M, 16F) had a diagnosis of secondary epilepsy and 10 a diagnosis of primary epilepsy. Of the 42 cases, 23 had had neurosurgical intervention post brain injury. Secondary epilepsy occurred with greater frequency in patients with traumatic brain injury (n=20), haemorrhagic stroke n=7), brain space occupying lesion (n=7) as compared to ischaemic stroke patients (n=3). 43%% (n=120) individuals were on anticonvulsants at admission for diverse reasons, mostly seizures 15.8% (n=44) and neuropathic pain 10% (n=28). In 33 patients out of 120, no clear indication was evident for their anticonvulsant prescription. Most frequently prescribed anticonvulsants were levetiracetam 21% (58), pregabalin 7.52% (21), sodium valproate 4.65% (13), and gabapentin 2.86% (8). Eleven patients had seizures during admission and in three, seizures occurred during weaning of anti-convulsants. Seizure rescue medication i.e. buccal midazolam was prescribed for 7 of 279 on discharge. Conclusion Secondary epilepsy is common in this population examined. It was more prevalent in those who underwent neurosurgical intervention. Seizures and neuropathic pain were main reasons to be on anticonvulsants. Levetiracetam was the most commonly prescribed agent. Weaknesses of the study were the retrospective study design, the poverty of detail on seizure type, reasons for prescription of anticonvulsants and reliance on accuracy of discharge letters. Qualitative work is needed to look at experience of epilepsy in this group with long term follow up to help inform education, discussions and treatment.

The association between dementia and epilepsy: A systematic review and meta-analysis.

Dementia is among the top 15 conditions with the most substantial increase in burden of disease in the past decade, and along with epilepsy, among the top 25 causes of years lived with disability worldwide. The epidemiology of dementia in persons with epilepsy, and vice versa, is not well characterized. The purpose of this systematic review was to examine the prevalence, incidence, and reported risk factors for dementia in epilepsy and epilepsy in dementia. Embase, PsycINFO, MEDLINE, and the Cochrane databases were searched from inception. Papers were included if they reported the incidence and/or prevalence of dementia and epilepsy. Two individuals independently performed duplicate abstract and full-text review, data extraction, and quality assessment. Random-effects models were used to generate pooled estimates when feasible. Of the 3,043 citations identified, 64 were reviewed in full text and 19 articles were included. The period prevalence of dementia ranged from 8.1 to 17.5 per 100 persons among persons with epilepsy (insufficient data to pool). The pooled period prevalence of epilepsy among persons with dementia was 5 per 100 persons (95% confidence interval [CI] 1-9) in population-based settings and 4 per 100 persons (95% CI 1-6) in clinic settings. There were insufficient data to report a pooled overall incidence rate and only limited data on risk factors. There are significant gaps in knowledge regarding the epidemiology of epilepsy in dementia and vice versa. Accurate estimates are needed to inform public health policy and prevention, and to understand health resource needs for these populations.

Epilepsy and treatment gap in urban and rural areas of the Southern Kazakhstan in adults.

There are no data in the English literature about the epidemiology of epilepsy in the large countries in the Asian region of the former Soviet Union. This paper presents the results of epidemiological studies of active epilepsy in the population 14years of age and older in the Province of South Kazakhstan. The study population consisted of 306.44 thousand persons: 139.42 in the urban Enbekshinskiy district of the city of Shymkent and 167.02 in the rural Sairam district. To collect patient's data, multiple medical sources were used. For each person with epilepsy (PWE), a questionnaire was completed by members of the research team. Clinical profiles, seizure type, clinical syndrome, etiology, seizure frequency, therapy, educational level, and social status were abstracted. Overall, 1351 PWE were identified: 459 in the urban district and 892 in the rural district. The age-adjusted prevalence of epilepsy was 3.14/1000 (CI95%: 2.86-3.45) in the urban district and 4.95/1000 (CI95%: 4.62-5.30) in the rural district. Prevalence for men was higher than for women. Focal seizures predominated in both regions. Traumatic brain injury was the most frequently identified cause of epilepsy. The other important antecedents were pre/perinatal disorders, CNS infection, and cerebrovascular disease. Half of PWE experienced more than 12seizures per year. Substantial social impacts of epilepsy were observed: 44% of PWE received disability pensions from the government; only 15.5% were employed. About a quarter of all PWE were not taking AEDs at the time of the record review. For those on treatment, regimens were frequently suboptimal. In the first study performed according to the guidelines for epidemiologic studies on epilepsy of ILAE in the Asian part of the former Soviet Union, poor seizure control and a substantial treatment gap were identified. The need for improvement of epilepsy care was highlighted, especially in the rural regions.

Prevalence and Incidence of Drug-Resistant Mesial Temporal Lobe Epilepsy in the United States.

We reviewed data on the epidemiology of epilepsy in the United States and estimated the prevalence and incidence of drug-resistant temporal lobe epilepsy (TLE) due to hippocampal sclerosis (HS) based on extrapolation from the available data drawn from the literature. We searched the electronic database PubMed on December 14, 2016, using the following search terms in the title: "epilepsy" OR "temporal lobe" OR "hippocampal sclerosis" AND "epidemiology" OR "prevalence" OR "incidence." Relevant original studies were included. We also reviewed several previous systematic reviews, meta-analyses, and their references. We concluded that the estimated current U.S. prevalence of drug-resistant HS-TLE is 0.51-0.66 cases per 1000 people, and the estimated U.S. incidence is 3.1-3.4 cases per 100,000 people per year. Based on a U.S. population of 324 million, we estimate that as many as 143,000-191,000 U.S. patients still suffer from drug-resistant HS-TLE and are in need of surgery or other therapeutic options. Although full scale epidemiologic studies on drug-resistant HS-TLE are needed, several observational studies allow adequate estimates of the range for the incidence and prevalence of this condition. Given the morbidity and mortality associated with poorly controlled seizures, this relatively large and growing patient population is a matter of concern. Considering the variety of treatment options that are available or in the pipeline to treat drug-resistant epilepsy, future efforts should focus on advocating for early referral of patients with drug-resistant HS-TLE for more comprehensive epilepsy management.

The epidemiology of epilepsy in children in the Republic of Belarus

To study the incidence of epilepsy in children in the Republic of Belarus based on the data of the Republican Centre for disease control. Statistical analysis of the incidence and morbidity of epilepsy in children and adolescents was performed. Based on this analysis, the contribution of epilepsy in the neurologic morbidity in childhood was analyzed. The morbidity and incidence of epilepsy in children averaged 0.35 and 2.4 per 1000 of the child population, respectively, over the last 6 years (2009-2014). The peak incidence of primary epilepsy is between the ages 1-4 years (0.43 per 1000 population for 12 years (2003-2014), of incidence of epilepsy among children, aged 0-17 years, are stable with no significant fluctuations for the last 6 years (2009-2014). The proportion of epilepsy in the structure of neurological disorders (9.51%) remained unchanged. In the period 2003-2014, general incidence of epilepsy among children, aged 5-9 years, has increased from 2.2 to 2.6 per 1000 child population (p<0.05) and from 2.5 to 3.8 (p<0.05) in children, aged 15-18 years, with no changes in the morbidity.

Fast Facts: Epilepsy

“Fast Facts: Epilepsy” by M.J. Brodie, S.C. Schachter, P. Kwan, Health Press, Fifth Edition. 2012. ISBN 978-1-908541-12-3 This is the 5th edition of a popular handbook on epilepsy, first published in 1999, which updates the 4 edition published in 2009. Condensed into 140 pages, the book touches on epilepsy epidemiology, classification, diagnosis, and management. There is a comprehensive discussion of old and new antiepileptic drugs and very brief discussion of epilepsy surgery, therapeutic devices, and diets. Owing to the compact nature of the book, each of these topics is discussed only superficially, with the exception of antiepileptic drugs. The two chapters dealing with pharmacology – the general treatment approach as wel as details about specific drugs – are the greatest strength of this book. Overall, the book is very readable, with a fresh, direct style. It is small enough to fit into a lab coat pocket, and I envision that those pockets will belong to medical students or perhaps resident physicians in fields related to neurology such as internal medicine, family medicine, pediatrics, or rehabilitation medicine. The book is clearly not intended for specialists in epilepsy or even, I suspect, general adult or pediatric neurologists. The content, with the exception of certain tables in the pharmacology chapters, is too simplified to be much use to physicians who regularly treat patients with epilepsy. Certain specific aspects of the text could be improved for better accuracy and readability. This edition continues to use the old International League Against Epilepsy classifications of seizures and epilepsies, rather than updating those classifications with the current, preferred nomenclature. Some important, newly recognized epilepsy syndromes of relevance to child neurologists are not discussed, such as feverinduced refractory epileptic seizures or fever-induced refractory epileptic encephalopathy in school-aged children. The authors continue to use the term “seizure disorder”, disfavored in modern parlance as a nonspecific substitute for “epilepsy”. Another unfortunate word choice is “devastating” with reference to LennoxGastaut syndrome; true, patients with Lennox-Gastaut often have major neurologic impairments, but labeling them as devastated does them a disservice. Many parents of my acquaintance would reel at their child being categorized as devastated. Facts about prognosis are welcome; opinions about quality of life are best omitted. Moving beyond nomenclature, the authors state that temporal lobe epilepsy is “often” preceded by prolonged febrile seizures. Data as to how often this occurs would be informative here. There is little consensus on this point among authorities and it would be misleading for junior physicians to walk away with this conclusion. When discussing genetics, the authors state that the number of epilepsy genes is “set” to increase in coming years. Since the number of genes to be discovered is not on a predetermined schedule, the phrase “likely to” would be more accurate. *Address for correspondence: Carl E. Stafstrom, Department of Neurology, University of Wisconsin, Madison, WI, USA. Tel.: +1 608 262 2154; Fax: +1 608 263 0412; E-mail: stafstrom@neurology .wisc.edu. Journal of Pediatric Epilepsy 2 (2013) 93–94 DOI 10.3233/PEP-13043 IOS Press 93

Epidemiology of Epilepsy in Belarusian population: a Pilot Study. (P1.098)

Epidemiology of Epilepsy in Belarusian population: a Pilot Study. (P1.098)