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Epidemiology of epilepsy--recent achievements and future.

Epilepsy is a very common neurological disease. Reliable epidemiological data are of great importance for understanding the etiology and risk factors for its development. It is necessary to use standardized methodology for the results from epilepsy studies in different geographical regions to be comparable. Most of the epidemiological studies of epilepsy find an incidence rate of 20-70/100,000 per year (range 11-134/100,000). The state of the problem in Bulgaria and other countries of Eastern Europe is not adequately studied. It is considered that the figures are higher in the developing countries. Incidence is higher in men than in women and varies considerably with age--it is high in childhood, decreases in young people and rises again in the elderly. Only approximately 30% of the newly-registered cases can be assigned to one of the diagnostic categories. The studies identify an etiological factor in only about one third of all cases. The most commonly reported etiological factors are: cerebro-vascular disease, tumors, alcohol, head injuries, congenital factors and neuroinfections. Most of the developed countries report prevalence of active epilepsy in the range of 4-8/1000. The prevalence rates in Latin America and some African states are especially high. In Bulgaria by means of the system of regional psychoneurological dispensaries about 30,000 epilepsy patients are registered, but it may be assumed that their real number is over 60,000. Contemporary views on the prognosis of this disease are favorable--more than 70% of the diseased reach long-term remission. Different prognostic factors predicting the final outcome of epilepsy patients are described. Epilepsy patients exhibit more than 2 times higher mortality rate than the expected rate for the corresponding population. It is necessary to conduct additional projects, based on the available standardized methodology for epidemiological monitoring of epilepsy in different geographical regions, including Bulgaria.