Authors :
Presenting Author: Channa Buxbaum, MPH – Institute for Health Metrics and Evaluation
Rebecca Hsu, MPA – Institute for Health Metrics and Evaluation
Liane Ong, PhD – Institute for Health Metrics and Evaluation
Mohsen Naghavi, MD, PhD, MPH – Institute for Health Metrics and Evaluation School of Medicine
Jaimie Steinmetz, PhD – Institute for Health Metrics and Evaluation
Samuel Wiebe, MD MSc – University of Calgary
Rationale:
Epilepsy is one of the most common serious neurological disorders, affecting individuals of all ages worldwide. Using data from the Global Burden of Disease (GBD) Study 2023, we assess global patterns in epilepsy mortality and explore variation across time and region. We also analyze multiple cause of death (MCOD) data to consider whether observed trends reflect differences in coding practices and cause-of-death attribution as well as true epidemiological shifts.
Methods:
In the GBD Study, epilepsy mortality is defined as deaths in which epilepsy is the underlying cause, most commonly identified through vital registration or verbal autopsy data. We analyzed data from GBD 2023, which includes 4,131 sources that identify epilepsy as an underlying cause of death. Approximately 91% of these are vital registration sources, and 4% are verbal autopsy, the latter of which are primarily from countries in South Asia and sub-Saharan Africa. Using an ensemble modeling approach, we estimated epilepsy deaths globally. To further investigate observed trends, we explored MCOD data from 21 countries, which include vital registration, hospital data, and vital registration linked to hospital data. We examined data where epilepsy was identified as the underlying cause of death, as well as deaths where epilepsy was a contributing (chain) cause, but not the underlying cause.
Results:
We estimated approximately 160,915 deaths globally attributable to epilepsy in 2024, accounting for 0.26% of total deaths worldwide. Age-standardized mortality remained relatively stable globally, with a modest decrease from 2.12 (95% UI 1.54–2.7) per 100,000 in 1980 to 1.95 (95% UI 1.53–2.51) in 2024. Regional trends are heterogeneous; some of the 21 GBD regions – such as High-income North America, High-income Asia Pacific, and Tropical Latin America – showed rising mortality rates, while declines were observed in East Asia and North Africa and the Middle East.
Among deaths where epilepsy was the underlying cause, common chain causes included cardiac arrest, acute respiratory failure, lower respiratory infection, and sepsis. These patterns were consistent by sex and stable from 2015 to 2022, though they varied by age group. When epilepsy appeared as a chain cause, the most frequent underlying causes included stroke, ischemic heart disease, dementia, lower respiratory infection, and brain and central nervous system cancer. In countries with at least 100 recorded epilepsy-related deaths, the proportion of deaths where epilepsy was considered the underlying cause—out of all deaths where epilepsy appears anywhere in the causal chain—ranged from 13.9% in Pakistan to 83.7% in Mongolia.
Conclusions:
Regional variation in both age-standardized mortality and cause-of-death attribution highlights the complexity of interpreting epilepsy-related deaths. MCOD data offer valuable insights into mortality patterns and potential misclassification, helping to contextualize global and regional mortality trends.
Funding: No funding was received in support of this abstract.