The prevalence of epilepsy along the Arizona-Mexico border

SummaryPurposeThis study describes the epidemiology of epilepsy on the Arizona-Mexico border.MethodsHouseholds in Southern Arizona were identified using two strategies. County-wide random digit dialing telephone surveys were supplemented with door-to-door recruitment in three Arizona border communities. Utilizing a two-step screening process, individuals with a seizure disorder or epilepsy were identified. A consensus diagnosis was arrived at after reviewing results from the detailed interview, medical records and clinical examination.ResultsA total of 15,738 household individuals were surveyed. Two hundred and three individuals were identified as having had epilepsy at some point in their life; 25% of them were previously not diagnosed. The sex and age-adjusted prevalence estimate was 14.3 per 1000 (95% CI: 12.5-16.1) for lifetime epilepsy, and 11.8 per 1000 (CI: 10.2-13.5) for active epilepsy (seizures in the past 5 years or currently taking antiseizure medications). Non-Hispanic Whites were two times more likely to have active epilepsy than Hispanics. The majority of individuals with lifetime history of epilepsy had idiopathic or cryptogenic epilepsy; most were localization-related epilepsy although the exact location could not be determined for the majority. Although most individuals with epilepsy report receiving care from a neurology specialist, they were more likely to have visited a non-specialist in the past 3 months.SignificanceThe lower prevalence of epilepsy among Hispanics compared to non-Hispanics supports previous survey findings in the Southwest US and may be due to language, acculturation factors, stigma, or a reflection of the “healthy immigrant effect”. The surprisingly high proportion of previously un-diagnosed individuals shows a need for further investigation as well as a need to increase community awareness.