All children 3 years of age on Jan 1, 1975 in Fuchu City, Tokyo, a total of 17,044 of a population of 182,000, were examined neurologically at the Health Center and the Dept of Genetics, Tokyo Metropolitan Institute for Neurosciences, Tokyo, Japan. Those with a history of seizures were compared with a randomly selected group of healthy children from the same population. The incidence of epilepsy (recurrent nonfebrile seizures) up to age 3 yrs was .43% and that of a single nonfebrile seizure was .47%. Febrile convulsions had occurred in 8.2%. By age 9-14 yrs the total cumulative incidence of epilepsy was .82%. Epilepsy developed in 50% of children with single nonfebrile seizures, in 2% of those with febrile convulsions, .2% of healthy 3-yr-old children, and in 2% of potential seizure patients with spike EEG abnormalities observed at 3 yrs of age. The author stresses identification and treatment of patients with potential seizure disorders. [1]

COMMENT. This study provides detailed statistics of the incidence of febrile convulsions, nonfebrile seizures and epilepsy in Japan. Of particular interest are the relatively high frequency of febrile convulsions in Japan c.f. US and Europe (8.2 v 3%), and the low incidence of epilepsy among potential healthy carriers with EEG seizure activity in the general population (2%). Methods for the prevention of clinical seizures in potentially epileptic subjects were not addressed although this goal was proposed. Most authorities would not advocate the use of long-term prophylactic anticonvulsant medication in healthy children with abnormal EEGs or in those with a history of one febrile convulsion uncomplicated by nonfebrile seizures.

Two epidemiological studies of epilepsy in India reported in the same issue of Epilepsia showed prevalence rates of .3-.4% for children and adolescent age groups. Males predominated and mental retardation and cerebral palsy were the most frequently associated conditions.