Nimal Senanayake The impact of geographic, climatic, demographic, social, and economic charac
teristics in developing countries is adverse in terms of the frequency of epilepsy. Information is relatively limited, and actions have to be based frequently on dra matic numbers; in Malawi between 1983 and 1986,60% of psychiatric outpatients and 30% of all psychiatric and neurological cases were related to epilepsy.1 Most of the earlier epidemiological studies on epilepsy in developing countries derived the information from hospital-based data, which made extrapolation to the general popu lation highly conjectural. Both the hospital-based and recent population-based studies reported a higher prevalence of epilepsy when compared to developed countries. The reasons for this high prevalence are not precisely known, but is attributed to some of the geographically specific etiological factors such as premature birth and birth-related injuries, traumatic brain injury, and infections including multiple para sitism.2 This chapter reviews the epidemiology of epilepsy in developing countries.