Epilepsy Care for Adults Needs Improvement

This article discusses epilepsy care in adults and how the standard of care needs to be improved.

Only about half the U.S. adults with active epilepsy see a specialist for their condition, the CDC reported Friday.

In 2010 about 1% of those 18 or older reported a diagnosis of epilepsy coupled with recent seizures or with medication to control attacks – so-called "active" epilepsy, agency researchers reported in the Nov. 16 issue ofMorbidity and Mortality Weekly Report.

Another 0.8% had been diagnosed with the condition but reported they had not had a seizure in the previous year and were not taking medication – defined as "inactive" epilepsy.

But in both groups, the proportion that reported recent consultation with a specialist was low – 53.4% and 6.9%, respectively.

Combined, just 33.4% of those with any history of epilepsy had visited a neurologist or epilepsy specialist in the previous year, the CDC analysis showed.

The findings are based on data from the 2010 National Health Interview Survey, an annual cross-sectional survey of the civilian, non-institutionalized U.S. population. Statistical software applied to the survey respondents generates population estimates, the agency noted.

Based on the 27,139 adults surveyed, the researchers estimated that there are 4.1 million adults in the U.S. who have been diagnosed with the condition, including 2.3 million with active and 1.7 million with inactive disease.

While they appeared to make limited use of specialty care, they were more likely to visit a generalist physician than the non-epileptic population, the agency found.

Specifically, 86.4% of adults with active epilepsy and 76.6% of those with any form of the condition had visited a generalist in the previous 12 months, compared with 66.1% of those without epilepsy.

The agency also found that the prevalence of the condition did not vary by age, sex, or education, but those with a history of epilepsy were more likely to be white or black or to live in families at the lowest income level.

For example, among those living in families with annual incomes of $34,999 or less, 3.1% reported a history of epilepsy and 1.9% had active disease.

The agency cautioned that the estimates are based on self-reported data and could be subject to reporting bias. In addition, reported cases are not classified by seizure type, severity, or etiology and some other forms of seizure might have been misclassified, inflating the prevalence estimates.

The findings form a baseline, the agency noted, from which a Healthy People 2020 objective can be developed.

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