Epilepsy

Epilepsy is of unexpectedly high frequency and severity in many parts of the world. About six out of every 1,000 people worldwide have epilepsy and about 30 percent of epileptics are not helped by medication. In developing countries, where medical care has been too expensive and insufficient, the total prevalence may reach 4 per 100 of the population, and frequent severe seizures have been reported in 1 per 100. Epilepsy presents an important mental health and public health problem, not only because of its serious economic implications but also through its social impact on the family and the community. For example, the economic cost of epilepsy in the USA in 1975 is estimated to be over 3 billion dollars, including unemployment, underemployment, excessive mortality, treatment costs, care for the severely disabled, drug costs, vocational rehabilitation, special education and research in epilepsy. Furthermore, severe epilepsy causes serious disability and has a high mortality. For various reasons, including superstition, many patients are not brought for treatment. In one study nearly three quarters of the people studied had intellectual, behavioural or neurological handicaps. Children with epilepsy only have a few problems at school and those with additional problems have many difficulties. A higher percentage of people with epilepsy are unemployed, in part because of the additional risk of injury on the job and transportation to and from work. Approximately 50% of persons with epilepsy die directly or indirectly because of the condition. With modern methods the condition can probably be controlled in 75% of patients. An unnecessary burden of disability therefore exists.