In this review article, Fiest and colleagues have provided a rigorous, quantitative summary of epilepsy prevalence and incidence studies globally. Interestingly, they identified outliers in LMICs (low- and middle-income countries) in Latin America, Africa, and the Middle East with higher than expected numbers of cases. As noted by the authors, this might be due to unique influences in these regions related to infection, consanguinity or other causes not routinely captured in epidemiologic studies. They also found active annual period and lifetime prevalence and incidence rates were higher in LMICs, but point prevalence was not. Unfortunately, this may be due to higher mortality rates among people with epilepsy. Something already well-documented in China.1
- Birbeck G, Hesdorffer D. The geography of epilepsy: a fatal disease in resource-poor settings. Neurology 2011;77:96-97.