I read the study of Morgan et al on social deprivation and prevalence of epilepsy and associated health usage1 with great interest and would like to add some remarks from my experience in the most impoverished region of the United States, near the Mississippi Delta. I would caution that it is especially in a poor and traumatised population, extremely difficult to differentiate between true electrical events and non-epileptic (or pseudo) seizures.2 We have known since Charcot about the correlation between psychological traumatic states, to which poverty is intimately related and conducive, and “hysterical” …

Dr M P Kerr. KerrMP{at}cf.ac.uk