215 patients with epilepsy and 125 healthy controls were questioned on the effects of epilepsy on social functioning as part of a population-based study of epilepsy in Northern Ecuador. 144 of these patients and 98 of the controls were followed, over a period of 1 year during an intervention study and then-response to treatment assessed. Economic, intellectual and social functioning were examined. In the patient group, function was affected in important areas, most clearly, work. The low opinion the community had of the intellectual and physical abilities of patients might affect a patient''s own view of themselves and sometimes diminish their opportunity for development. At 12 months, as a result of treatment, a significantly lower level of patients reported effects on function in some areas, though control individuals'' views of their functional impairment had not shifted to any extent. Moreover, despite improvement, more patients at 12 months acknowledged fear of seizures, especially their unpredictability, as a handicapping factor, particularly in working outside or away from home. This seems to indicate that even when seizures are controlled, for many patients, the uncertainties of the condition remain and continue to affect their view of their capabilities.