TY - JOUR
T1 - Global, regional, and national burden of epilepsy, 1990–2021
T2 - a systematic analysis for the Global Burden of Disease Study 2021
AU - GBD Epilepsy Collaborators
AU - Feigin, Valery L.
AU - Vos, Theo
AU - Nair, Balakrishnan Sukumaran
AU - Hay, Simon I.
AU - Abate, Yohannes Habtegiorgis
AU - Abd Al Magied, Abdallah H.A.
AU - Abd ElHafeez, Samar
AU - Abdelkader, Atef
AU - Abdollahifar, Mohammad Amin
AU - Abdullahi, Auwal
AU - Aboagye, Richard Gyan
AU - Abreu, Lucas Guimarães
AU - Rumeileh, Samir Abu
AU - Abualruz, Hasan
AU - Aburuz, Salahdein
AU - Abu-Zaid, Ahmed
AU - Addo, Isaac Yeboah
AU - Adedoyin, Rufus Adesoji
AU - Adepoju, Abiola Victor
AU - Afzal, Muhammad Sohail
AU - Afzal, Saira
AU - Ahmad, Aqeel
AU - Ahmad, Sajjad
AU - Ahmad, Tauseef
AU - Ahmadi, Ali
AU - Ahmadzade, Amir Mahmoud
AU - Ahmed, Ayman
AU - Ahmed, Haroon
AU - Ahmed, Mehrunnisha Sharif
AU - Ahmed, Muktar Beshir
AU - Awaidy, Salah Al
AU - Omari, Omar Al
AU - Al-Ajlouni, Yazan
AU - Albashtawy, Mohammed
AU - Al-Fatly, Bassam
AU - Algammal, Abdelazeem M.
AU - Ali, Abid
AU - Ali, Mohammed Usman
AU - Ali, Syed Shujait
AU - Ali, Waad
AU - Alif, Sheikh Mohammad
AU - Uy Almazan, Joseph
AU - Alshahrani, Najim Z.
AU - Altaf, Awais
AU - Al-Wardat, Mohammad
AU - Al-Worafi, Yaser Mohammed
AU - Aly, Hany
AU - Alzoubi, Karem H.
AU - Bhaskar, Sonu
AU - Naik, Ganesh R.
N1 - Publisher Copyright:
© 2025 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
PY - 2025/3
Y1 - 2025/3
N2 - Background: Epilepsy is one of the most common serious neurological disorders and affects individuals of all ages across the globe. The aim of this study is to provide estimates of the epilepsy burden on the global, regional, and national levels for 1990–2021. Methods: Using well established Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) methodology, we quantified the prevalence of active idiopathic (epilepsy of genetic or unknown origin) and secondary epilepsy (epilepsy due to an underlying abnormality of the brain structure or chemistry), as well as incidence, death, and disability-adjusted life-years (DALYs) by age, sex, and location (globally, 21 GBD regions and seven super-regions, World Bank country income levels, Socio-demographic Index [SDI], and 204 countries) and their trends from 1990 to 2021. Vital registrations and verbal autopsies provided information about deaths, and data on the prevalence and severity of epilepsy, largely came from population representative surveys. All estimates were calculated with 95% uncertainty intervals (UIs). Findings: In 2021, there were 51·7 million (95% UI 44·9–58·9) people with epilepsy (idiopathic and secondary combined) globally, with an age-standardised prevalence of 658 per 100 000 (569–748). Idiopathic epilepsy had an age-standardised prevalence of 307 per 100 000 (235–389) globally, with 24·2 million (18·5–30·7) prevalent cases, and secondary epilepsy had a global age-standardised prevalence of 350 per 100 000 (322–380). In 2021, 0·7% of the population had active epilepsy (0·3% attributed to idiopathic epilepsy and 0·4% to secondary epilepsy), and the age-standardised global prevalence of epilepsy from idiopathic and secondary epilepsy combined increased from 1990 to 2021 by 10·8% (1·1–21·3), mainly due to corresponding changes in secondary epilepsy. However, age-standardised death and DALY rates of idiopathic epilepsy reduced from 1990 to 2021 (decline of 15·8% [8·8–22·8] and 14·5% [4·2–24·2], respectively). There were three-fold to four-fold geographical differences in the burden of active idiopathic epilepsy, with the bulk of the burden residing in low-income to middle-income countries: 82·1% (81·1–83·4) of incident, 80·4% prevalent (79·7–82·7), 84·7% (83·7–85·1) fatal epilepsy, and 87·9% (86·2–89·2) epilepsy DALYs. Interpretation: Although the global trends in idiopathic epilepsy deaths and DALY rates have improved in the preceding decades, in 2021 there were almost 52 million people with active epilepsy (24 million from idiopathic epilepsy and 28 million from secondary epilepsy), with the bulk of the burden (>80%) residing in low-income to middle-income countries. Better treatment and prevention of epilepsy are required, along with further research on risk factors of idiopathic epilepsy, good-quality long-term epilepsy surveillance studies, and exploration of the possible effect of stigma and cultural differences in seeking medical attention for epilepsy.
AB - Background: Epilepsy is one of the most common serious neurological disorders and affects individuals of all ages across the globe. The aim of this study is to provide estimates of the epilepsy burden on the global, regional, and national levels for 1990–2021. Methods: Using well established Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) methodology, we quantified the prevalence of active idiopathic (epilepsy of genetic or unknown origin) and secondary epilepsy (epilepsy due to an underlying abnormality of the brain structure or chemistry), as well as incidence, death, and disability-adjusted life-years (DALYs) by age, sex, and location (globally, 21 GBD regions and seven super-regions, World Bank country income levels, Socio-demographic Index [SDI], and 204 countries) and their trends from 1990 to 2021. Vital registrations and verbal autopsies provided information about deaths, and data on the prevalence and severity of epilepsy, largely came from population representative surveys. All estimates were calculated with 95% uncertainty intervals (UIs). Findings: In 2021, there were 51·7 million (95% UI 44·9–58·9) people with epilepsy (idiopathic and secondary combined) globally, with an age-standardised prevalence of 658 per 100 000 (569–748). Idiopathic epilepsy had an age-standardised prevalence of 307 per 100 000 (235–389) globally, with 24·2 million (18·5–30·7) prevalent cases, and secondary epilepsy had a global age-standardised prevalence of 350 per 100 000 (322–380). In 2021, 0·7% of the population had active epilepsy (0·3% attributed to idiopathic epilepsy and 0·4% to secondary epilepsy), and the age-standardised global prevalence of epilepsy from idiopathic and secondary epilepsy combined increased from 1990 to 2021 by 10·8% (1·1–21·3), mainly due to corresponding changes in secondary epilepsy. However, age-standardised death and DALY rates of idiopathic epilepsy reduced from 1990 to 2021 (decline of 15·8% [8·8–22·8] and 14·5% [4·2–24·2], respectively). There were three-fold to four-fold geographical differences in the burden of active idiopathic epilepsy, with the bulk of the burden residing in low-income to middle-income countries: 82·1% (81·1–83·4) of incident, 80·4% prevalent (79·7–82·7), 84·7% (83·7–85·1) fatal epilepsy, and 87·9% (86·2–89·2) epilepsy DALYs. Interpretation: Although the global trends in idiopathic epilepsy deaths and DALY rates have improved in the preceding decades, in 2021 there were almost 52 million people with active epilepsy (24 million from idiopathic epilepsy and 28 million from secondary epilepsy), with the bulk of the burden (>80%) residing in low-income to middle-income countries. Better treatment and prevention of epilepsy are required, along with further research on risk factors of idiopathic epilepsy, good-quality long-term epilepsy surveillance studies, and exploration of the possible effect of stigma and cultural differences in seeking medical attention for epilepsy.
UR - https://www.scopus.com/pages/publications/85219077855
U2 - 10.1016/S2468-2667(24)00302-5
DO - 10.1016/S2468-2667(24)00302-5
M3 - Article
AN - SCOPUS:85219077855
SN - 2468-2667
VL - 10
SP - e203-e227
JO - The Lancet Public Health
JF - The Lancet Public Health
IS - 3
ER -