Neuroepidemiology of Epilepsy in Northwest India

BACKROUND: Epilepsy has a complex etiology characterised by recurring seizures. PURPOSE: To study clinical profile of epilepsy patients with reference to type of epilepsy in northwest India. No previous Indian study has reported relative incidence of various types of seizures with reference to type of epilepsy. METHODS: Data of 400 epilepsy patients (200 idiopathic and 200 symptomatic) was collected for their clinical characteristics. The classification of epilepsy into idiopathic and symptomatic types was done on the basis of findings of EEG, CT scan and MRI tests. RESULTS: The age of onset of seizures was less than 15 years in only one third of the total patients. The number of non-vegetarians was higher in SE (68.5%) than IE (58%). The male to female ratio was significantly higher (1.33:1 in IE and 1.47:1 in SE). No difference was seen for place of residence (urban vs rural) patients with epilepsy (PWE). The majority of patients (58.5% of symptomatic and 52.8% idiopathic) though reported no triggering factors, yet many of them, when questioned, had held supernatural powers to be the cause of the disease. Sleep deprivation was reported as a major triggering factor by 28.5% of idiopathic epilepsy (IE) and 25% of symptomatic epilepsy (SE) patients. The incidence of mental retardation (1.25%) and behavioral disorders (7%) was found to be relatively low. Loss of memory was reported in 46% of IE and 43.5% of SE and poor scholastic performance in 23% of IE and 16.5% of SE. A positive history was recorded in 11% first-degree relatives and 4% second-degree relatives. Generalized seizures were more common in IE patients (67.5%), while partial seizures with and without secondary generalization (50.5%), and generalized seizures (49.5%) were equally common in SE. Conclusions: The study demonstrates differences in the type of seizures between idiopathic and symptomatic epilepsies and not other demographic, clinical and psycho-social traits. The males were found to have higher risk of epilepsy than females. The epidemiological characteristics of epileptics show variations across populations and also within population.