A population-based study of the prevalence, clinical characteristics and effect of ethnicity in epilepsy

The aim of this study was to determine the prevalence and clinical characteristics of epilepsy and seizure disorders in Bradford. The method used was a community-based cross-sectional study. Case ascertainment was by review of medical records identified by searching practice databases using diagnostic codes and from repeat prescribing data. A specialist epilepsy nurse reviewed the records in 39 practices covering a population of 225 439. Clinical review was undertaken where there was limited information available in the records. In total, 1643 cases of epilepsy were identified (prevalence 7.3/1000). The prevalence of epilepsy increased with age. Classification of patients by internationally agreed definitions showed 1013 (62%) of cases with active epilepsy (prevalence 4.5/1000); 421 (26%) with epilepsy in remission on treatment and 209 (13%) with epilepsy in remission off treatment. The standardized rate for all patients of South Asian origin was 3.6/1000 compared to 7.8/1000 in the rest of the population (OR 0.46; 95% CI 0.38, 0.57). An underlying aetiology was identified in 29.5% of cases. Cerebrovascular disease and head injuries were the commonest causes. Conclusions: The prevalence of epilepsy supports previous epidemiological estimates and highlights the public health importance of epilepsy. The low prevalence in the South Asian population is a surprising finding and further research into cultural attitudes to epilepsy and the impact of stigma in the South Asian population in the UK is required. (C) 2000 BEA Trading Ltd.