Abstracts

Rationale: Misdiagnosis and missed diagnosis of epilepsy may delay appropriate treatment and in some cases, be dangerous. In this presentation, characteristics of individuals who had been told by a provider that they have epilepsy will be compared with those who were found to have epilepsy but were never formally diagnosed. The results were obtained from a multi-year prevalence study in Arizona counties along the Arizona-Mexico border. Methods: Households in Cochise, Santa Cruz, and Yuma Counties were recruited through random digit dialing (county-wide) and door to door visits (border cities only). Household residents were screened twice for epilepsy. They were first asked if a provider had ever told them they have epilepsy or a seizure disorder, and they were also screened using a previously validated screening tool. Those who screened positive with either method were interviewed further to obtain information about their seizures, risk factors, medical service utilization, and quality of life. When possible, they were also evaluated by a study physician. Two study physicians independently classified seizure type according to the ILAE classification system. Results: To date, information on approximately 15,000 household residents have been screened, 67% of whom are Hispanics, 52.3% are females, and 37% below the age of 25 years. Half of the total sample was from the door to door recruitment even though these surveys were conducted in a shorter time period, and targeted a smaller area. Of the 171 individuals who reported being diagnosed with epilepsy, 4 had provoked or febrile seizures, and 15 may have been misdiagnosed (i.e., do not appear to have provoked seizures or epilepsy). One in four (25.8%) individuals considered to have epilepsy, by study physicians, was never diagnosed by a doctor. Conclusions: Results suggest that errors in diagnosis and missed diagnoses of epilepsy may be more frequent than originally expected. (Supported by a grant from the CDC.)