Because epilepsy is a nonreportable disease, it is difficult to arrive at reasonable estimates of its incidence. Perhaps half the cases in the United States are preventable in the sense that they are the sequelae of trauma, infections, birth injury, and so forth, with clear damage to the brain, the seizures appearing as a secondary symptom of the underlying brain damage. In cases of cerebral palsy or mental deficiency, epileptic seizures are often the least dramatic of the symptoms. These secondary cases are more frequent when there is poor prenatal and perinatal care and in populations suffering from poverty with its attendant overcrowding, malnutrition, neglect, and violence. From a world health point of view, epilepsy is a very common and disabling condition, particularly in regions where there is a high incidence of low virulence central nervous system infections causing secondary cases, and where traumas, particularly the subdural hematomas of infancy and early childhood, are neglected.

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