An estimate of the true prevalence of epilepsy in a rural Appalachian population.

Relationship between reported and true prevalence of seizures in communities are often confounded by such factors as: availability of appropriate diagnostic and therapeutic resources, sophistication of medical records and disease reporting systems, a uniform definition of cases the social implications of the disease in that area. Through applications of an epidemiologic survey, monitored to take these factors into account, we have developed data which are considered an accurate estimate of the true prevalence of seizures in the school age population of a relatively isolated mountain community of 19 000. Analysis suggested a 50% greater prevalence of seizures than expected from other studies of similar age groups. Although exact comparison of these data with data from other studies is hampered by variation in definitions, there is a strong suggestion that a high rate of seizures does exist in this community. Some possible explanations are examined and plans for further investigation are described. The methodology employed in the survey is presented as a potential model for consideration.