J Neurol (2001) 248 : 762 – 767 © Steinkopff Verlag 2001 ORIGINAL COMMUNICATION A. Luengo J. Parra J. Colás F. Rámos T. Carreras M.J. Fernández-Pozos A. Muñoz V. Hernando Prevalence of Epilepsy in Northeast Madrid JON 510 Introduction Epilepsy is a common health problem with a worldwide distribution. Information about the prevalence and dis- tribution of epileptic seizures is limited. Nevertheless, such data are essential either in effective health care planning or for providing a hypothesis about causation. Epidemiological studies suffer from variations in the de- finition of epilepsy. The inclusion of patients with seizures not meeting criteria for epilepsy is a frequent cause of inaccurate results [47]. Other limitations in studies of epilepsy include the selection of partial sub- groups of populations, [5, 10, 11, 14, 17, 33, 39, 40, 43, 47] the use of antiepileptic drugs (AEDs) as markers for epilepsy [22, 42] and the retrospective nature of some of these. The awareness of some of these limitations in the epi- demiological data on epilepsy in Spain led us to design a survey of the prevalence of epilepsy in our area [14, 17]. The purpose of the present study was to estimate the prevalence of epilepsy among people over 10 years of age in a specific health district in Spain. The study area in- volved a population of nearly 100,000 inhabitants in a geographically well-defined health district. Patients and methods In Spain, the public health system covers up to 97% of the population [48]. This, at the time of the study, is made of two assistance levels: a) Primary Care integrated in Health Centres, b) Specialised Care de- pendent on the Area Hospital [50]. The study was of a population in- side the industrial belt of Madrid, which comprises four neighbour- ing towns that form a closed health district under the jurisdiction of the Public Health Assistance. The towns surveyed were Coslada (de- signed as I) with 75.229 inhabitants, San Fernando de Henares (II) with 27.088 inhabitants, Mejorada del Campo (III) with 13.865 inhab- itants and Velilla de San Antonio (IV) with 3.057 inhabitants (National Statistic Institute of Spain, December 1994), where demographic in- formation is easily available. Each of the 55 general practitioners of the health area has a code number, and is in charge of 1.750 to 1.950 adult inhabitants. They at- tend an average of 25 patients (range 23–30) a day, on weekdays; of these and the rest on follow up patients an average of five (range 3–8) are new referrals. The present study has been accomplished in the outpatient neurological service, which has been in Coslada for the last eight years. We established two phases in the survey.The first phase aimed at identifying patients with paroxysmal conditions and/or disorders of Received: 10 November 1999 Received in revised form: 6 February 2001 Accepted: 6 March 2001 A. Luengo · J. Parra · J. Colás · F. Rámos · T. Carreras · M.J. Fernández-Pozos · A. Muñoz · V. Hernando “Jaime Vera”, Coslada University Hospital “Princesa” U. A. M. Madrid, Spain A. Luengo Dos Santos () Paseo de las Acacias, 49 1˚, B 28005 Madrid, Spain Tel.: + 34-9 15 17 56 93 e-mail: lramosc@meditex.es ■ Abstract During a period of 42 months, we studied the prevalence of epilepsy in a specific health dis- trict, composing by four towns with 98,405 inhabitants older than 10 years. This has been accom- plished by a two-phase cross-sec- tional study. The prevalence rate observed was 4.12/1000 inhabitants for all types of epilepsy. No signifi- cant differences were found be- tween the sexes. Sixty-three per cent of affected individuals had partial seizures, with a confirmed cause in 45 %. Fifty-five patients with single unprovoked seizures, were also identified but not in- cluded in the prevalence rate. ■ Key words Epilepsy · Prevalence · Aetiology · Seizure type · Epidemiology