About 3 million American adults reported active epilepsy in 2015 — a doctor-diagnosed seizure disorder with current medication, a seizure in the past year, or both. Epilepsy, especially with uncontrolled seizures, brings physical, neurological and mental health problems, cognitive and physical difficulties, medication side effects, more injuries and deaths, poorer quality of life and higher costs. Being seizure-free for a year brings many clinical and social benefits.
CDC analyzed the 2013 and 2015 National Health Interview Surveys, combining the answers of 68,174 adults.
Key findings
| 2013 | 2015 | Both years | |
|---|---|---|---|
| Adults with active epilepsy | 2,254,000 (0.9%) | 2,978,000 (1.2%) | about 2.6 million a year (1.1%) |
| Saw a neurologist or epilepsy specialist in the past year | 65.7% | 68.3% | 67% |
| Taking epilepsy medication | 86.3% | 93.0% | 90% |
| Seizure-free in the past year, among those on medication | 45.3% | 42.4% | 44% |
- Reported active epilepsy rose from 2.3 million adults in 2010 to 3 million in 2015, with about 724,000 more cases from 2013 to 2015. In 2010, only 52.8% had seen a specialist.
- Active epilepsy was more common among white and Black adults; people never married or divorced, separated or widowed; those without a high school diploma; the unemployed; and families below 200% of the federal poverty level.
- Adults who saw a specialist were more likely to take medication (95.4% vs 78.1%), but their seizure frequency wasn't different. Seeing a specialist was more common among adults 18–34, those with some college and those in the Northeast.
Visual abstract. From CDC's MMWR.
Who had their seizures controlled
Among adults taking epilepsy medication:
| Better seizure control | Worse seizure control | ||
|---|---|---|---|
| Age 65+ | 62.7% | Age 35–54 | 36.9% |
| Married or cohabiting | 50.0% | Divorced, separated or widowed | 31.5% |
| Employed | 54.3% | Unemployed | 37.7% |
| Income ≥200% of poverty level | 55.3% | Income <200% of poverty level | 33.2% |
| Northeast | 60.3% | South | 37.5% |
Epilepsy medication use and seizure frequency by specialty care in the past year, 2013 and 2015. From CDC's MMWR.
Why control lags
The Institute of Medicine estimates about 70% of people with epilepsy could become seizure-free with appropriate treatment — far above the 44% seen here. Cost and transportation can keep disadvantaged adults from care, including specialists, while lower education and social isolation — such as lacking support after divorce or widowhood — may lead to missed medication, a major obstacle to control. Older adults' better control may reflect differences in seizure causes, how drugs are processed, or better adherence, perhaps from experience managing other chronic conditions and better access to care, including Medicare drug coverage.
What can help
- Treatment tailored to each person — age at onset, seizure cause and type, other conditions, adherence, preferences and social circumstances.
- Better access to care, social support and self-management education to improve medication adherence.
- Avoiding seizure triggers such as lack of sleep, stress, flashing lights, and alcohol or drug use.
Limits: epilepsy was self-reported (though the questions are validated), may be over- or under-reported and excludes people in institutions; adherence and seizure frequency weren't measured objectively; the response rate was 58.2%; and differences by specialist care may be confounded by severity or conditions such as mood disorders.
Sources
Based on Tian N, Boring M, Kobau R, Zack MM, Croft JB, "Active Epilepsy and Seizure Control in Adults — United States, 2013 and 2015," Morbidity and Mortality Weekly Report 67(15), CDC; a work of the United States government in the public domain.
Licence: CC0 1.0 (public domain) · Adapted from www.cdc.gov
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