CC BY-NC-ND 4.0 · International Journal of Epilepsy 2017; 04(01): 065-069
DOI: 10.1016/j.ijep.2017.03.001
Review article
Thieme Medical and Scientific Publishers Private Ltd.

A first-ever dedicated comprehensive review of incidence of epilepsy in South America and Caribbean

Devender Bhalla
a   Nepal Interest Group of Epilepsy and Neurology, Kathmandu, Nepal
b   Iran Epilepsy Association, Tehran, Iran
Saloni Kapoor
c   All India Institute of Medical Sciences, Delhi, India
Ani Kapoor
c   All India Institute of Medical Sciences, Delhi, India
Elham Lotfalinezhad
c   All India Institute of Medical Sciences, Delhi, India
d   Center for Research on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
Fatemah Amini
c   All India Institute of Medical Sciences, Delhi, India
d   Center for Research on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
Nanda Kishor Bhatta
a   Nepal Interest Group of Epilepsy and Neurology, Kathmandu, Nepal
Kavita Srivastava
e   Department of Neurology, Bharathi Vidyapeeth University, India
Manjari Tripathi
c   All India Institute of Medical Sciences, Delhi, India
› Author Affiliations
Further Information

Publication History

Received: 18 September 2016

Accepted: 14 March 2017

Publication Date:
06 May 2018 (online)


In order to understand true incident burden of epilepsy in South America and Caribbean, several sources were searched in multiple languages using keywords and combinations. The results were presented as counts, proportions, means, and/or medians along with their 95% confidence intervals (CI). No information was found from Caribbean and no information was available from six South American countries. Based on 14 estimates, annual median incidence (N = 185319, 1984–2010, 7 in rural area) of epilepsy for South America was 115.2/100,000 (95% CI 61.0–133.4, range 0.0–410.0). Random-effect pooled annual epilepsy incidence was 84.8/100,000 (95% CI 65.2–104.5). The 25th and 75th percentile of annual epilepsy incidence were 62.2/100,000 and 130.9/100,000 respectively with an interquartile range (IQR) of 68.7. Between-study variance attributable to each explanatory factor was estimated to be: 38.8% from study year, 18.1% from urban-rural milieu, 15.4% from case size, and 0.6% from study size. Descriptively, on average, 445824 (between 236070 and 516258) new cases of epilepsy are possibly occurring every year in South America. In conclusion, Caribbean needs to come forward for its own epilepsy incidence data especially when risk from numerous factors such as substance abuse, mental health, etc. deems high. Epilepsy incidence in South America is likely to be slightly lower than previously reported although this varies considerably for each country. Inter-population differences are in-part (more than 50%) related to urban-rural differences and variations over time. Our work is especially important to monitor secular trends of epilepsy incidence especially when new data would emerge and countries continue to undergo transitions.

  • References

  • 1 Mathern GW, Beninsig L, Nehlig A. Reasons for discrepancy between incidence and prevalence of epilepsy in lower income countries: epilepsia's survey results. Epilepsia 56 2015; 163-165
  • 2 Bhalla D, Tchalla AE, Marin B. et al. Epilepsy: Asia versus Africa. Epilepsia 55 2014; 1317-1321
  • 3 Bell GS, Neligan A, Sander JW. An unknown quantity – the worldwide prevalence of epilepsy. Epilepsia 55 2014; 958-962
  • 4 Beghi E, Hesdorffer D. Prevalence of epilepsy – an unknown quantity. Epilepsia 55 2014; 963-967
  • 5 Declaration of Santiago on epilepsy in Latin America. Epilepsia 43 Suppl. (6) 2002; 42
  • 6 Burneo JG, Tellez-Zenteno J, Wiebe S. Understanding the burden of epilepsy in Latin America: a systematic review of its prevalence and incidence. Epilepsy Res 66 2005; 63-74
  • 7 Bhalla D, Aziz H, Bergen D. et al. Undue regulatory control on phenobarbital – an important yet overlooked reason for the epilepsy treatment gap. Epilepsia 56 2015; 659-662
  • 8 Bhalla D, Lotfalinezhad E, Timalsina U. et al. A comprehensive review of epilepsy in the Arab World. Seizure. 2015 in press
  • 9 Wit JM. Morbidity and mortality patterns among pediatric patients in Dominica (West Indies). Bull Pan Am Health Organ 17 1983; 164-176
  • 10 Raccurt CP, Agnamey P, Boncy J, Henrys JH, Totet A. Seroprevalence of human Taenia solium cysticercosis in Haiti. J Helminthol 83 2009; 113-116
  • 11 Hernandez-Cossio O, Hernandez-Fustes OJ. Neurocysticercosis and epilepsy in Cuba. Rev Neurol 29 1999; 1003-1006
  • 12 Hernandez-Cossio O, Hernandez-Oramas N, Enriquez-Caceres M, Hernandez-Fustes OJ. Etiology of late-onset epilepsy. Rev Neurol 32 2001; 628-630
  • 13 Hun C, Hok T, Bhalla D. Epilepsy: some controversies, some knowledge and some experience from Cambodia. Neurol India 62 2014; 606-609
  • 14 Shibahara I, Osawa S, Kon H. et al. Increase in the number of patients with seizures following the Great East-Japan Earthquake. Epilepsia 54 2013; e49-52
  • 15 Mas Bermejo P. Preparation and response in case of natural disasters: cuban programs and experience. J Public Health Policy 27 2006; 13-21
  • 16 Singh H, Maharaj HD, Shipp M. Pattern of substance abuse among secondary school students in Trinidad and Tobago. Public Health 105 1991; 435-441
  • 17 UNODC. Global Study on Homicide – trends, context, data. 2011. United Nations; Vienna, Austria: p. 93
  • 18 Singh H, Mustapha N. Some factors associated with substance abuse among secondary school students in Trinidad and Tobago. J Drug Educ 24 1994; 83-93
  • 19 World Bank. Countries and economies. 2016. World Bank; Washington DC, USA:
  • 20 Ngugi AK, Kariuki SM, Bottomley C. et al. Incidence of epilepsy: a systematic review and meta-analysis. Neurology 77 2011; 1005-1012
  • 21 Bruno E, Bartoloni A, Zammarchi L. et al. Epilepsy and neurocysticercosis in Latin America: a systematic review and meta-analysis. PLoS Negl Trop Dis 7 2013; e2480
  • 22 Gonzales I, Miranda JJ, Rodriguez S. et al. Seizures, cysticercosis and rural-to-urban migration: the PERU MIGRANT study. Trop Med Int Health 20 2015; 546-552
  • 23 Daviglus ML, Talavera GA, Aviles-Santa ML. et al. Prevalence of major cardiovascular risk factors and cardiovascular diseases among Hispanic/Latino individuals of diverse backgrounds in the United States. JAMA 308 2012; 1775-1784
  • 24 Lopez-Ruiz M, Artazcoz L, Martinez JM, Rojas M, Benavides FG. Informal employment and health status in Central America. BMC Public Health 15 2015; 698
  • 25 Alarcon RD. Mental health and mental health care in Latin America. World Psychiatry 2 2003; 54-56
  • 26 Aragon A, Partanen T, Felknor S, Corriols M. Social determinants of workers' health in Central America. Int J Occup Environ Health 17 2011; 230-237
  • 27 Hauser WA, Annegers JF, Kurland LT. Prevalence of epilepsy in Rochester, minnesota: 1940–1980. Epilepsia 32 1991; 429-445
  • 28 Medina MT, Aguilar-Estrada RL, Alvarez A. et al. Reduction in rate of epilepsy from neurocysticercosis by community interventions: the Salama, Honduras study. Epilepsia 52 2011; 1177-1185
  • 29 Nicolás O, Francis Enrique V, Reyna D, Marco Tulio M. Aspectos socio-culturales y antropológicos que inciden en la determinación de la prevalencia de las epilepsias en la étnia misquita del departamento de Gracias a Dios, Honduras. Rev Med Hond 70 2002; 9-14
  • 30 Medina MT, Duron R, Ramirez F. et al. Prevalencia de enfermedades neurológicas en Tegucigalpa: el estudio Kennedy. Rev Med Hond 71 2003; 8-17
  • 31 GLAE. Prevalencia e incidencia de la epilepsia en el pais Guatemala. 2001. Guatemala League against Epilepsy; Guatemala City: 1-13
  • 32 Rodríguez ACF, Menjívar AM. Evaluacion de resutados en siete casos de cirucia para epilepsia mediamente intratable en pacientes de edad pediatrica en El Salvador. 2010. Universidad Jose Delgado; La Libertad, El Salvador: 1-150
  • 33 Stokes HB, Salguero LF. Epidemiologia de las epilepsias en Guatemala. Medina MT, Sell FC, Calix NC, Gracia FG. Las epilepsia en Centro America. 2001. Scan Color; Tegucigalpa: 32-36
  • 34 Garcia-Noval J, Moreno E, de Mata F. et al. An epidemiological study of epilepsy and epileptic seizures in two rural Guatemalan communities. Ann Trop Med Parasitol 95 2001; 167-175
  • 35 Brackette C, Cindrella A. Prevalencia de epilepsia y enfermedad cerebro vascular en la Aldea El Rosario Municipio de Río Hondo Zacapa, del 1 de marzo al 30 de abril de 1998. 1998. University of San Carlos; Guatemala City: 1-79
  • 36 Kuestermann CSA. Factores de riesgo para la epilepsia en el área de Cerro Alto San Juan Sacatepequez. 1995. Universidad Francisco Marroquín; Guatemala City: 1-88
  • 37 Nunes ML, Geib LT, Grupo A. Incidence of epilepsy and seizure disorders in childhood and association with social determinants: a birth cohort study. J Pediatr (Rio J) 87 2011; 50-56
  • 38 Lavados J, Germain L, Morales A, Campero M, Lavados P. A descriptive study of epilepsy in the district of El Salvador, Chile, 1984–1988. Acta Neurol Scand 85 1992; 249-256
  • 39 Placencia M, Shorvon SD, Paredes V. et al. Epileptic seizures in an Andean region of Ecuador: incidence and prevalence and regional variation. Brain 115 Pt. (03) 1992; 771-782
  • 40 Villaran MV, Montano SM, Gonzalvez G. et al. Epilepsy and neurocysticercosis: an incidence study in a Peruvian rural population. Neuroepidemiology 33 2009; 25-31
  • 41 LIVECE. Liga Venezolana contra la Epilepsia- Reunion Caracas. 2016. Liga Venezolana Contra la Epilepsia; Venezuela:
  • 42 Bruno E, Quattrocchi G, Crespo Gomes EB. et al. Prevalence and incidence of epilepsy associated with convulsive seizures in rural Bolivia. A global campaign against epilepsy project. PLoS One 10 2015; e0139108