[The prevalence of different types of epilepsy in clinical practice]

The author reviews the frequency with which different parameters are observed in the 7,500 patients included in his database, created in 1974 and last reviewed in June 2000. The objective of this review is not to do an epidemiological study, but exclusively for the evaluation of the characteristics of the patients who have attended the clinic in recent years. Since the population considered is not complete, but a particular transverse sector, strictly speaking it cannot be considered to be an epidemiological study. It is possible to make a hypothetical extrapolation from this data of a selected population to a general population.

We made a retrospective study of the database including 3,000 patients seen between 1974 and 1985. Between 1985 and 2000, 4,500 cases were analyzed prospectively. There were 7,500 patients altogether.

Regarding the types of seizures and their associations, the commonest were the association of simple partial crises and secondarily generalized partial seizures as seen in 661 patients (8.81%). Rather less often there were complex partial crises associated with secondarily generalized partial crises, seen in 640 patients (8.53%). We thus show the frequency of seizures of partial epilepsy. With regard to the types of epilepsy, we point out that the commonest is partial epilepsy (40.86%), to which one should add the cases of so called unilateral epilepsy (398 patients, 5.3%) which was greater than those with generalized epilepsy (idiopathic and systemic and/or cryptogenic) (40.8%), with possible bias due to the origin of the cases. Finally, we mention the frequency of epileptic syndromes. The commonest syndrome seen we have labelled as partial, secondarily generalized epilepsy (6.57%). However, when the syndromes were strictly classified according to established criteria, this was only possible in 2,013 of the 7,500 patients (26.84%). We interpret this, as recently described by Lombroso, as indicating a need for extension of the current classification of epileptic syndromes.