Prevalence and clinical characteristics of active epilepsy in southern Han Chinese.

PURPOSE: To investigate the prevalence and clinical characteristics of active epilepsy in southern Han Chinese. METHOD: A door-to-door survey about epilepsy was conducted in communities identified by random cluster sampling among 20 villages and 3 communities of Yueyang city. A questionnaire for epilepsy based on the World Health Organization screening questionnaire was used. A final diagnosis of epilepsy was made by neurology specialists with the support of head magnetic resonance imaging (MRI), computed tomography (CT), and electroencephalography (EEG) if available. The prevalence, clinical characteristics, and treatment gap were analyzed in patients with active epilepsy within the past year and the past 5 years. RESULTS: Active epilepsy was identified in 91 patients within the past year and 117 patients within the past 5 years. The one-year prevalence was 2.8‰, and the five-year prevalence was 3.7‰. The prevalence for epilepsy active within the last year and the last five years was significantly higher in rural areas than in urban areas (P<0.05). Secondary generalized tonic-clonic seizures (53.8%) were the most common seizure type in patients whose epilepsy had been active in the last year. 34.1% of patients were diagnosed with structural or metabolic epilepsy. The most common cause for epilepsy was cerebrovascular disease (32.3%), followed by traumatic brain injury (29.0%). The treatment gap was 93.4%. CONCLUSION: The prevalence of epilepsy active within the last one and five years was higher in rural areas than in urban areas of Yueyang city. A large treatment gap exists in this area and a rational intervention strategy is needed.

Investigation of prevalence, clinical characteristics and management of epilepsy in Yueyang city of China by a door-to-door survey.

BACKGROUND: The aim of this study was to establish the prevalence rate, types and causes of epilepsy, and information on treatment gap of epilepsy in Yueyang city, and to evaluate the diagnosis and treatment status of these patients. METHODS: A door-to-door epidemiological survey on epilepsy was conducted by random cluster sampling among the urban and rural populations of Yueyang city, Hunan province, China. The screening questionnaire for epilepsy used in this study was adapted from the WHO and ICBERG standard screening questionnaires. All peoples diagnosed with epilepsy or suspected to be epileptic during screening were rechecked by neurologists. Clinical and treatment data were collected from patients with definitive diagnosis. RESULTS: A total of 32059 peoples were screened. 143 peoples were diagnosed with epilepsy. Lifetime prevalence rate was 4.5‰ and 1-year active prevalence rate was 2.8‰. Prevalence rates were higher in male and rural areas. Secondary generalized tonic-clonic seizure prevailed over other seizure types in frequency. 93.4% of the patients with active epilepsy had treatment gaps without receiving standard and regular antiepileptic drugs before the survey. CONCLUSIONS: The prevalence rate of epilepsy in Yueyang is lower than in other areas of China and Asia. The large amount of patients with treatment gaps indicates an urgent need for a rational intervention strategy.