Global, regional, and national burden of epilepsy, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Feigin, V.L.; Vos, T.; Nair, B.S.; Hay, S.I.; Abate, Y.H.; Abd Al Magied, A.H.A.; Abd Elhafeez, S.; Abdelkader, A.; Abdollahifar, M.-.; Abdullahi, A.; Aboagye, R.G.; Abreu, L.G.; Abu Rumeileh, S.; Abualruz, H.; Aburuz, S.; Abu-Zaid, A.; Addo, I.Y.; Adedoyin, R.A.; Adepoju, A.V.; Afzal, M.S.; Afzal, S.; Ahmad, A.; Ahmad, S.; Ahmad, T.; Ahmadi, A.; Ahmadzade, A.M.; Ahmed, A.; Ahmed, H.; Ahmed, M.S.; Ahmed, M.B.; Al Awaidy, S.; Al Omari, O.; Al-Ajlouni, Y.; Albashtawy, M.; Al-Fatly, B.; Algammal, A.M.; Ali, A.; Ali, M.U.; Ali, S.S.; Ali, W.; Alif, S.M.; Almazan, J.U.; Alshahrani, N.Z.; Altaf, A.; Al-Wardat, M.; Al-Worafi, Y.M.; Aly, H.; Alzoubi, K.H.; Amiri, S.; Ancuceanu, R.; Angappan, D.; Ansari, M.T.; Anvari, S.; Anyasodor, A.E.; Arabloo, J.; Arafat, M.; Aravkin, A.Y.; Aregawi, B.B.; Aremu, A.; Atout, M.M.W.; Atreya, A.; Aujayeb, A.; Aychiluhm, S.B.; Aziz, S.; Azzam, A.Y.; Badiye, A.D.; Bai, R.; Baig, A.A.; Bakkannavar, S.M.; Bandyopadhyay, S.; Banerjee, I.; Bardhan, M.; Barker-Collo, S.L.; Barrow, A.; Basharat, Z.; Bashiri, A.; Basiru, A.; Bastan, M.-.; Batchu, S.; Behnam, B.; Bejarano Ramirez, D.F.; Bemanalizadeh, M.; Beyene, K.A.; Bhagat, D.S.; Bhagavathula, A.S.; Bhaskar, S.; Bhat, A.N.; Bhatti, G.K.; Bhatti, J.S.; Bhuiyan, M.A.; Bhuyan, S.S.; Bilgin, C.; Bisulli, F.; Boloor, A.; Boppana, S.H.; Bouaoud, S.; Bustanji, Y.; Cakmak Barsbay, M.; Carvalho, F.; Castaldelli-Maia, J.M.; Chandika, R.M.; Chattu, V.K.; Chaudhary, A.A.; Ching, P.R.; Chopra, H.; Chu, D.-.; Chu, H.; Cortese, S.; Cortesi, P.A.; Cruz-Martins, N.; Dadras, O.; Dai, X.; D'Amico, E.; Dandona, L.; Dandona, R.; Darcho, S.D.; Darwish, A.H.; Dhane, A.S.; Dhulipala, V.R.; Diaz, M.J.; T. C., D.; Dohare, S.; Doshi, O.P.; Dsouza, H.L.; Dziedzic, A.M.; Ebrahimi, A.; Eissazade, N.; Ekholuenetale, M.; El Arab, R.A.; El Bayoumy, I.F.; El Meligy, O.A.A.; Elhabashy, H.R.; Elhadi, M.; Eltaha, C.; Fagbamigbe, A.F.; Fahim, A.; Fares, J.; Farjoud Kouhanjani, M.; Fasanmi, A.O.; Fatehizadeh, A.; Fazeli, P.; Fazylov, T.; Fekadu, G.; Fereshtehnejad, S.-.; Ferrara, P.; Ferreira, N.; Fetensa, G.; Fischer, F.; Foschi, M.; Gadanya, M.A.; Galali, Y.; Ganesan, B.; Gao, X.; Garg, R.K.; Gebregergis, M.W.; Ghadirian, F.; Ghamari, S.-.; Gilani, J.A.; Girmay, A.A.; Giussani, G.; Gnedovskaya, E.V.; Golechha, M.; Gouravani, M.; Grada, A.; Guan, S.-.; Gupta, S.; Haghani Dogahe, M.; Haj-Mirzaian, A.; Hamdy, N.M.; Harlianto, N.I.; Hasaballah, A.I.; Hasani, H.; Hassan, A.; Hassan, I.I.; Hassan Zadeh Tabatabaei, M.S.; Hegazi, O.E.; Heidari, G.; Hemmati, M.; Hezam, K.; Hoan, N.Q.; Holla, R.; Hosseinzadeh, M.; Huang, J.; Huynh, H.-.; Hwang, B.-.; Ibitoye, S.E.; Ikiroma, A.; Ilesanmi, O.S.; Ilic, I.M.; Ilic, M.D.; Imam, M.T.; Immurana, M.; Inok, A.; Islam, M.R.; Iwu, C.D.; Jacob, L.; Jafarzadeh, A.; Jahrami, H.; Jairoun, A.A.; Jakovljevic, M.; Jalilzadeh Yengejeh, R.; Jamora, R.D.G.; Jawaid, T.; Jayapal, S.K.; Ji, Z.; Jonas, J.B.; Joseph, N.; Joshua, C.E.; Kabir, Z.; Kalani, R.; Kamireddy, A.; Kanmodi, K.K.; Kapoor, N.; Kashoo, F.Z.; Kaur, H.; Kazemi, F.; Khajuria, H.; Khalilian, A.; Khan, M.; Khatatbeh, H.; Khayat Kashani, H.R.; Kheirallah, K.A.; Khidri, F.F.; Khormali, M.; Khosla, A.A.; Khubchandani, J.; Kim, Y.J.; Kim, Y.S.; Kimokoti, R.W.; Koh, H.Y.; Kolahi, A.-.; Kostev, K.; Krishan, K.; Krishnamoorthy, V.; Kruja, J.; Kuddus, M.; Kulimbet, M.; Kumar, G.A.; Kumar, M.; Kundu, S.; Kyto, V.; Lahariya, C.; Lal, D.K.; Lam, J.; Landires, I.; Lanfranchi, F.; N. H. H., L.; Lee, S.W.; Ligade, V.S.; Lim, S.S.; Linehan, C.; Liu, X.; Liu, X.; Lopez-Gil, J.F.; Lucchetti, G.; Majeed, A.; Malhotra, K.; Malik, A.A.; Mansouri, V.; Marateb, H.R.; Martorell, M.; Marzo, R.R.; Mathangasinghe, Y.; Mediratta, R.P.; Mehndiratta, M.M.; Meles, H.N.; Melese, E.B.; Mensah, G.A.; Meretoja, A.; Mestrovic, T.; Mettananda, S.; Minervini, G.; Mirfakhraie, R.; Mirza, M.; Misganaw, A.; Misra, A.K.; Mohamed, A.Z.; Mohamed, N.S.; Mohammadian-Hafshejani, A.; Mohammadzadeh, I.; Mohan, S.; Mokdad, A.H.; Monasta, L.; Moodi Ghalibaf, A.; Moradi, M.; Motappa, R.; Muccioli, L.; Mulita, F.; Munkhsaikhan, Y.; Murillo-Zamora, E.; Muthu, S.; Nabavi, A.; Naik, G.R.; Nargus, S.; Nashwan, A.J.; Natto, Z.S.; Nauman, J.; Naveed, M.; Nayak, B.P.; Nazri-Panjaki, A.; Nepal, G.; Netsere, H.B.; Nguyen, H.T.H.; Niazi, R.K.; Nikoobar, A.; Nozari, M.; Nri-Ezedi, C.A.; Nwatah, V.E.; Nzoputam, O.J.; Oancea, B.; Olagunju, A.T.; Olalusi, O.V.; Omar Bali, A.; Ordak, M.; Orish, V.N.; Ortiz-Prado, E.; Otstavnov, N.; Ouyahia, A.; Owolabi, M.O.; Padron-Monedero, A.; Padubidri, J.R.; Panda, S.K.; Panda-Jonas, S.; Pande Katare, D.; Pandey, A.; Panos, L.D.; Pantazopoulos, I.; Papadopoulou, P.; Parekh, U.; Parikh, R.R.; Parsons, N.; Passera, R.; Patil, S.; Pawar, S.; Pazoki Toroudi, H.; Pensato, U.; Peprah, P.; Peres, M.F.P.; Perna, S.; Pham, H.N.; Piracha, Z.Z.; Piradov, M.A.; Poddighe, D.; Poluru, R.; Pour-Rashidi, A.; Pradhan, J.; Prasad, M.; Pribadi, D.R.A.; Puvvula, J.; Qasim, N.H.; Radhakrishnan, V.; Raghav, P.; Rahim, F.; Rahman, M.; Rahmani, A.M.; Rahmanian, M.; Raja, A.; Rajabpour Sanati, A.; Rajpoot, P.L.; Ramadan, M.M.; Ramasamy, S.K.; Rancic, N.; Rao, S.J.; Rashidi, M.-.; Rathish, D.; Rawaf, S.; Reddy, M.M.R.K.; Redwan, E.M.M.M.; Rezaeian, M.; Rhee, T.G.; Riaz, M.; Rodriguez, J.A.B.; Roever, L.; Romozzi, M.; Rony, M.K.K.; Root, K.T.; Rout, H.S.; Saad, A.M.A.; Sabet, C.J.; Saddik, B.A.; Sadeghian, R.; Saeb, M.R.; Saeed, U.; Saeed, U.; Saheb Sharif-Askari, F.; Saheb Sharif-Askari, N.; Sahebkar, A.; Saif, Z.; Sajadi, S.M.; Salami, A.A.; Salimi, S.; Samodra, Y.L.; Samy, A.M.; Sarode, G.S.; Sarode, S.C.; Sathian, B.; Sathyanarayan, A.; Satpathy, M.; Sawhney, M.; Selvaraj, S.; Semreen, M.H.; Sendekie, A.K.; Senthilkumaran, S.; Sethi, Y.; Seylani, A.; Shahbandi, A.; Shahid, S.; Shaikh, M.A.; Shaikh, S.Z.; Shamim, M.A.; Shams-Beyranvand, M.; Shamsutdinova, A.; Sharifan, A.; Sharifi Rad, J.; Sharma, A.; Sharma, V.; Shayan, M.; Sheikh, Z.B.; Shetty, M.; Shetty, P.H.; Shetty, P.K.; Shittu, A.; Shlobin, N.A.; Shorofi, S.A.; Shrestha, S.; Siddig, E.E.; Singh, G.; Singh, H.; Singh, J.A.; Singh, P.; Singh, P.; Singh, S.; Solanki, S.; Soraneh, S.; Stanikzai, M.H.; Sullman, M.J.M.; Sunnerhagen, K.S.; Suresh, V.; Swain, C.K.; Szarpak, L.; Tabaee Damavandi, P.; Tabares-Seisdedos, R.; Tabche, C.; Taiba, J.; Tanwar, M.; Tareke, M.; Temsah, M.-.; Temsah, R.M.H.; Teramoto, M.; Thangaraju, P.; Thirunavukkarasu, S.; Ticoalu, J.H.V.; Tiruye, T.Y.; Tiwari, K.; Tiwari, V.K.; Tovani-Palone, M.R.; Tran, T.H.; Tran Minh Duc, N.; Tripathi, M.; Tromans, S.J.; Tsai, D.H.-.; Tsatsakis, A.; Tsermpini, E.E.; Tumurkhuu, M.; Udoakang, A.J.; Ullah, S.; Umair, M.; Unnikrishnan, B.; Urso, D.; Usman, J.S.; Vaithinathan, A.G.; Vakilian, A.; Varma, R.P.; Venketasubramanian, N.; Villafane, J.H.; Vinayak, M.; Vinueza Veloz, A.F.; Walde, M.T.; Wang, S.; Wang, Y.; Waris, A.; Wickramasinghe, N.D.; Winkler, A.S.; Yesuf, S.A.; Yigit, A.; Yigit, V.; Yilma, M.T.; Yismaw, Y.E.; Yon, D.K.; Yonemoto, N.; Yu, C.; Zandi, M.; Zanghi, A.; Zeariya, M.G.M.; Zhao, Z.; Zhong, C.C.; Zielinska, M.; Zitoun, O.A.; Zyoud, S.H.; Zyoud, S.H.; Rautalin, I.; Newton, C.R.J.; Wiebe, S.; Murray, C.J.L.

doi:10.1016/S2468-2667(24)00302-5

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. Funding: Bill and Melinda Gates Foundation

Global, regional, and national burden of epilepsy, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021 / V.L. Feigin, T. Vos, B.S. Nair, S.I. Hay, Y.H. Abate, A.H.A. Abd Al Magied, S. Abd Elhafeez, A. Abdelkader, M.-. Abdollahifar, A. Abdullahi, R.G. Aboagye, L.G. Abreu, S. Abu Rumeileh, H. Abualruz, S. Aburuz, A. Abu-Zaid, I.Y. Addo, R.A. Adedoyin, A.V. Adepoju, M.S. Afzal, S. Afzal, A. Ahmad, S. Ahmad, T. Ahmad, A. Ahmadi, A.M. Ahmadzade, A. Ahmed, H. Ahmed, M.S. Ahmed, M.B. Ahmed, S. Al Awaidy, O. Al Omari, Y. Al-Ajlouni, M. Albashtawy, B. Al-Fatly, A.M. Algammal, A. Ali, M.U. Ali, S.S. Ali, W. Ali, S.M. Alif, J.U. Almazan, N.Z. Alshahrani, A. Altaf, M. Al-Wardat, Y.M. Al-Worafi, H. Aly, K.H. Alzoubi, S. Amiri, R. Ancuceanu, D. Angappan, M.T. Ansari, S. Anvari, A.E. Anyasodor, J. Arabloo, M. Arafat, A.Y. Aravkin, B.B. Aregawi, A. Aremu, M.M.W. Atout, A. Atreya, A. Aujayeb, S.B. Aychiluhm, S. Aziz, A.Y. Azzam, A.D. Badiye, R. Bai, A.A. Baig, S.M. Bakkannavar, S. Bandyopadhyay, I. Banerjee, M. Bardhan, S.L. Barker-Collo, A. Barrow, Z. Basharat, A. Bashiri, A. Basiru, M.-. Bastan, S. Batchu, B. Behnam, D.F. Bejarano Ramirez, M. Bemanalizadeh, K.A. Beyene, D.S. Bhagat, A.S. Bhagavathula, S. Bhaskar, A.N. Bhat, G.K. Bhatti, J.S. Bhatti, M.A. Bhuiyan, S.S. Bhuyan, C. Bilgin, F. Bisulli, A. Boloor, S.H. Boppana, S. Bouaoud, Y. Bustanji, M. Cakmak Barsbay, F. Carvalho, J.M. Castaldelli-Maia, R.M. Chandika, V.K. Chattu, A.A. Chaudhary, P.R. Ching, H. Chopra, D.-. Chu, H. Chu, S. Cortese, P.A. Cortesi, N. Cruz-Martins, O. Dadras, X. Dai, E. D'Amico, L. Dandona, R. Dandona, S.D. Darcho, A.H. Darwish, A.S. Dhane, V.R. Dhulipala, M.J. Diaz, T.C. Do, S. Dohare, O.P. Doshi, H.L. Dsouza, A.M. Dziedzic, A. Ebrahimi, N. Eissazade, M. Ekholuenetale, R.A. El Arab, I.F. El Bayoumy, O.A.A. El Meligy, H.R. Elhabashy, M. Elhadi, C. Eltaha, A.F. Fagbamigbe, A. Fahim, J. Fares, M. Farjoud Kouhanjani, A.O. Fasanmi, A. Fatehizadeh, P. Fazeli, T. Fazylov, G. Fekadu, S.-. Fereshtehnejad, P. Ferrara, N. Ferreira, G. Fetensa, F. Fischer, M. Foschi, M.A. Gadanya, Y. Galali, B. Ganesan, X. Gao, R.K. Garg, M.W. Gebregergis, F. Ghadirian, S.-. Ghamari, J.A. Gilani, A.A. Girmay, G. Giussani, E.V. Gnedovskaya, M. Golechha, M. Gouravani, A. Grada, S.-. Guan, S. Gupta, M. Haghani Dogahe, A. Haj-Mirzaian, N.M. Hamdy, N.I. Harlianto, A.I. Hasaballah, H. Hasani, A. Hassan, I.I. Hassan, M.S. Hassan Zadeh Tabatabaei, O.E. Hegazi, G. Heidari, M. Hemmati, K. Hezam, N.Q. Hoan, R. Holla, M. Hosseinzadeh, J. Huang, H.-. Huynh, B.-. Hwang, S.E. Ibitoye, A. Ikiroma, O.S. Ilesanmi, I.M. Ilic, M.D. Ilic, M.T. Imam, M. Immurana, A. Inok, M.R. Islam, C.D. Iwu, L. Jacob, A. Jafarzadeh, H. Jahrami, A.A. Jairoun, M. Jakovljevic, R. Jalilzadeh Yengejeh, R.D.G. Jamora, T. Jawaid, S.K. Jayapal, Z. Ji, J.B. Jonas, N. Joseph, C.E. Joshua, Z. Kabir, R. Kalani, A. Kamireddy, K.K. Kanmodi, N. Kapoor, F.Z. Kashoo, H. Kaur, F. Kazemi, H. Khajuria, A. Khalilian, M. Khan, H. Khatatbeh, H.R. Khayat Kashani, K.A. Kheirallah, F.F. Khidri, M. Khormali, A.A. Khosla, J. Khubchandani, Y.J. Kim, Y.S. Kim, R.W. Kimokoti, H.Y. Koh, A.-. Kolahi, K. Kostev, K. Krishan, V. Krishnamoorthy, J. Kruja, M. Kuddus, M. Kulimbet, G.A. Kumar, M. Kumar, S. Kundu, V. Kyto, C. Lahariya, D.K. Lal, J. Lam, I. Landires, F. Lanfranchi, N.H.H. Le, S.W. Lee, V.S. Ligade, S.S. Lim, C. Linehan, X. Liu, X. Liu, J.F. Lopez-Gil, G. Lucchetti, A. Majeed, K. Malhotra, A.A. Malik, V. Mansouri, H.R. Marateb, M. Martorell, R.R. Marzo, Y. Mathangasinghe, R.P. Mediratta, M.M. Mehndiratta, H.N. Meles, E.B. Melese, G.A. Mensah, A. Meretoja, T. Mestrovic, S. Mettananda, G. Minervini, R. Mirfakhraie, M. Mirza, A. Misganaw, A.K. Misra, A.Z. Mohamed, N.S. Mohamed, A. Mohammadian-Hafshejani, I. Mohammadzadeh, S. Mohan, A.H. Mokdad, L. Monasta, A. Moodi Ghalibaf, M. Moradi, R. Motappa, L. Muccioli, F. Mulita, Y. Munkhsaikhan, E. Murillo-Zamora, S. Muthu, A. Nabavi, G.R. Naik, S. Nargus, A.J. Nashwan, Z.S. Natto, J. Nauman, M. Naveed, B.P. Nayak, A. Nazri-Panjaki, G. Nepal, H.B. Netsere, H.T.H. Nguyen, R.K. Niazi, A. Nikoobar, M. Nozari, C.A. Nri-Ezedi, V.E. Nwatah, O.J. Nzoputam, B. Oancea, A.T. Olagunju, O.V. Olalusi, A. Omar Bali, M. Ordak, V.N. Orish, E. Ortiz-Prado, N. Otstavnov, A. Ouyahia, M.O. Owolabi, A. Padron-Monedero, J.R. Padubidri, S.K. Panda, S. Panda-Jonas, D. Pande Katare, A. Pandey, L.D. Panos, I. Pantazopoulos, P. Papadopoulou, U. Parekh, R.R. Parikh, N. Parsons, R. Passera, S. Patil, S. Pawar, H. Pazoki Toroudi, U. Pensato, P. Peprah, M.F.P. Peres, S. Perna, H.N. Pham, Z.Z. Piracha, M.A. Piradov, D. Poddighe, R. Poluru, A. Pour-Rashidi, J. Pradhan, M. Prasad, D.R.A. Pribadi, J. Puvvula, N.H. Qasim, V. Radhakrishnan, P. Raghav, F. Rahim, M. Rahman, A.M. Rahmani, M. Rahmanian, A. Raja, A. Rajabpour Sanati, P.L. Rajpoot, M.M. Ramadan, S.K. Ramasamy, N. Rancic, S.J. Rao, M.-. Rashidi, D. Rathish, S. Rawaf, M.M.R.K. Reddy, E.M.M.M. Redwan, M. Rezaeian, T.G. Rhee, M. Riaz, J.A.B. Rodriguez, L. Roever, M. Romozzi, M.K.K. Rony, K.T. Root, H.S. Rout, A.M.A. Saad, C.J. Sabet, B.A. Saddik, R. Sadeghian, M.R. Saeb, U. Saeed, U. Saeed, F. Saheb Sharif-Askari, N. Saheb Sharif-Askari, A. Sahebkar, Z. Saif, S.M. Sajadi, A.A. Salami, S. Salimi, Y.L. Samodra, A.M. Samy, G.S. Sarode, S.C. Sarode, B. Sathian, A. Sathyanarayan, M. Satpathy, M. Sawhney, S. Selvaraj, M.H. Semreen, A.K. Sendekie, S. Senthilkumaran, Y. Sethi, A. Seylani, A. Shahbandi, S. Shahid, M.A. Shaikh, S.Z. Shaikh, M.A. Shamim, M. Shams-Beyranvand, A. Shamsutdinova, A. Sharifan, J. Sharifi Rad, A. Sharma, V. Sharma, M. Shayan, Z.B. Sheikh, M. Shetty, P.H. Shetty, P.K. Shetty, A. Shittu, N.A. Shlobin, S.A. Shorofi, S. Shrestha, E.E. Siddig, G. Singh, H. Singh, J.A. Singh, P. Singh, P. Singh, S. Singh, S. Solanki, S. Soraneh, M.H. Stanikzai, M.J.M. Sullman, K.S. Sunnerhagen, V. Suresh, C.K. Swain, L. Szarpak, P. Tabaee Damavandi, R. Tabares-Seisdedos, C. Tabche, J. Taiba, M. Tanwar, M. Tareke, M.-. Temsah, R.M.H. Temsah, M. Teramoto, P. Thangaraju, S. Thirunavukkarasu, J.H.V. Ticoalu, T.Y. Tiruye, K. Tiwari, V.K. Tiwari, M.R. Tovani-Palone, T.H. Tran, N. Tran Minh Duc, M. Tripathi, S.J. Tromans, D.H.-. Tsai, A. Tsatsakis, E.E. Tsermpini, M. Tumurkhuu, A.J. Udoakang, S. Ullah, M. Umair, B. Unnikrishnan, D. Urso, J.S. Usman, A.G. Vaithinathan, A. Vakilian, R.P. Varma, N. Venketasubramanian, J.H. Villafane, M. Vinayak, A.F. Vinueza Veloz, M.T. Walde, S. Wang, Y. Wang, A. Waris, N.D. Wickramasinghe, A.S. Winkler, S.A. Yesuf, A. Yigit, V. Yigit, M.T. Yilma, Y.E. Yismaw, D.K. Yon, N. Yonemoto, C. Yu, M. Zandi, A. Zanghi, M.G.M. Zeariya, Z. Zhao, C.C. Zhong, M. Zielinska, O.A. Zitoun, S.H. Zyoud, S.H. Zyoud, I. Rautalin, C.R.J. Newton, S. Wiebe, C.J.L. Murray. - In: THE LANCET PUBLIC HEALTH. - ISSN 2468-2667. - 10:3(2025 Mar), pp. e203-e227. [10.1016/S2468-2667(24)00302-5]

Global, regional, and national burden of epilepsy, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

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H.;Tran Minh Duc N.;Tripathi M.;Tromans S. J.;Tsai D. H. -T.;Tsatsakis A.;Tsermpini E. E.;Tumurkhuu M.;Udoakang A. J.;Ullah S.;Umair M.;Unnikrishnan B.;Urso D.;Usman J. S.;Vaithinathan A. G.;Vakilian A.;Varma R. P.;Venketasubramanian N.;Villafane J. H.;Vinayak M.;Vinueza Veloz A. F.;Walde M. T.;Wang S.;Wang Y.;Waris A.;Wickramasinghe N. D.;Winkler A. S.;Yesuf S. A.;Yigit A.;Yigit V.;Yilma M. T.;Yismaw Y. E.;Yon D. K.;Yonemoto N.;Yu C.;Zandi M.;Zanghi A.;Zeariya M. G. M.;Zhao Z.;Zhong C. C.;Zielinska M.;Zitoun O. A.;Zyoud S. H.;Zyoud S. H.;Rautalin I.;Newton C. R. J.;Wiebe S.;Murray C. J. L.^Ultimo

2025

Abstract

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. Funding: Bill and Melinda Gates Foundation

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	Settori scientifico-disciplinari dell'articolo (validi dal 09/05/2024)
	
				Settore MEDS-08/C - Scienza dell'alimentazione e delle tecniche dietetiche applicate
			
	Data di pubblicazione
	
				mar-2025
			
	Data ahead of print o data di stampa
	
				24-feb-2025
			
	Rivista in ANCE
	
				THE LANCET PUBLIC HEALTH
			
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				https://dx.doi.org/10.1016/S2468-2667(24)00302-5
			
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