Three Staged Epidemiological Survey of Pediatric Epilepsy in a Rural Suburb of Pune

Introduction: Epilepsy is the most common serious neurological disorder of childhood; more than 50% of seizures start in childhood. Prevalence rate of epilepsy is higher in developing countries.

Materials and Methods: This was a three-stage cross-sectional epidemiological survey to determine prevalence of childhood epilepsy in a rural population of ~42,000. At first stage, children between 2 months to 18 years (total = 9,487) were screened by validated screening questionnaire by a door to door survey by trained health workers. At second stage, those screened positive were assessed by pediatric neurologists by home visit. At third stage, those with history consistent with epilepsy underwent free EEG and advised about appropriate treatment. Treatment gap and knowledge, attitude, and practice (KAP) of mothers were also evaluated.

Results: In the first stage, 260 children were screened positive. In second stage, 31 had unequivocal seizures, excluding febrile seizures, breath holding spells, etc. Focal seizures were most common type of seizures and epilepsy. Point prevalence of pediatric epilepsy was 0.75 per 1,000 population. More than 50% of children with epilepsy had at least one associated comorbidity. EEG abnormality was in 61% with identified etiology in 55%, commonest being perinatal insult. Treatment gap was found to be 57%. A significant knowledge gap was found in our study.

Conclusion: Prevalence of epilepsy was found to be 0.75 per 1,000 population. There was a huge treatment gap and inappropriate KAP among the caregivers. To the best of our knowledge, study incorporating EEG in epidemiological survey of pediatric epilepsy is the first of its kind in India.