© JAPI • VOL. 56 • DECEMBER 2008

Abstract
Purpose : To test the usefulness of a simplified and clinically oriented, the Epidemiological Classification (EC), in
determination of seizure types and appropriate drug selection in epileptic patients at the primary care level.
Methods : The EC was applied to all epileptic patients over 5 years then compared with the currently recommended
international classifications of seizures and epilepsy (ICES/ICEES).
Results : A total of 1176 patients were enrolled with 2:1 male preponderance and 88% had onset of disease below
30 years of age. Based on EC, 682 (58%) had partial, 333 (28.3%) had generalized and 161 (13.7%) had undetermined
seizures semiology. When ICES was applied, seizure typing was same in 86.2%, 68.5% and 26.7% patients of partial,
generalized and unclassified seizures respectively. About 87% patients in generalized and partial seizure semiology
had no change in selected antiepileptic drug even after the ICES, but 53.6% patients in undetermined group had
change in selected AED. Only, 146 patients (12.5%) found to have symptomatic cause for seizure(s) on applying
the EC system. After utilizing the ICEES on 1030 patients (87.5%) of “unknown etiology” cases after the EC system,
almost 86.5% patients could be classified to a definite etiological class.
Conclusion : The EC was found useful for determination of seizure type and appropriate AEDs selection at the primary
care level. The ICES/ICEES works better at the tertiary care level. This “two-tier” system can be more effective for
overall epilepsy management in developing countries with limited facilities. ©