A descriptive study has documented what is felt to be a precise estimate of the prevalence of epilepsy in 1973 in the school-age population of Clay County, Kentucky, a rural Appalachian county. A 96% response rate was achieved from the target population of 5467. By utilizing an accepted definition of epilepsy, an experienced child neurologist and a carefully monitored survey method which required the cooperative efforts of school personnel, local public health nurses and community leaders, a prevalence significantly greater than that previously reported from other areas of this country was observed (p less than .05). The true prevalence of seizures in Clay County, Kentucky, children 6--16 years of age in 1973 is believed to have been between the observed rate of 27 cases per 1000 and the estimated rate of 35 cases per 1000. The prevalence rate of febrile seizures is believed to have been underestimated in the Clay County data. For comparative purposes, the authors are currently applying the same methodology to a non-Appalachian area.
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