Global, regional and national burden of epilepsy in children and adolescents, 1990-2021: A systematic analysis for the Global Burden of Disease Study 2021

Abstract

Background Epilepsy is a common neurological disease that heavily impacts children and adolescents and carries serious physical, cognitive, psychological, social and economic consequences for patients and their caregivers.Methods Data was obtained via the Global Burden of Disease Study 2021. We reported numbers, rates and percentage changes of prevalence, mortality and disability-adjusted life years (DALYs).Results In 2021, there were 18.15 million [95% UI: 14.61-21.85] prevalent cases of epilepsy in children and adolescents worldwide, 8.24 million [5.77-11.13] of which were idiopathic epilepsy and 9.91 million [8.72-11.06] of which were secondary epilepsy. While mortality and DALY rates of idiopathic epilepsy declined between 1990 and 2021, the burden of secondary epilepsy remained substantial and, in some cases, increased-particularly in low-SDI regions. The prevalence rate of secondary epilepsy increased by 16.14% [4.28-29.24], driven by increases in epilepsy attributable to neonatal encephalopathy (82.02%), neonatal jaundice (18.45%) and malaria (77.03%). There were notable geographic variations in the burden of epilepsy, with the burden generally concentrated in Sub-Saharan Africa, Latin America and the Caribbean and Southeast Asia.Conclusions While efforts to reduce premature mortality of epilepsy have been successful, the burden on children and adolescents living with epilepsy is still significant. A healthcare gap remains for vulnerable populations with increased risk of infectious diseases, perinatal insults, poor sanitation and limited access to healthcare. Global and national action is needed to improve access to specialist care and medication, manage comorbidities, address stigma and discrimination and strengthen primary prevention initiatives.