Global Burden of Epilepsy 1990 through 2021: Disparities and Sustained Increased Demand for Specialized Care
Abstract number :
2.112
Submission category :
16. Epidemiology
Year :
2025
Submission ID :
1219
Source :
www.aesnet.org
Presentation date :
12/7/2025 12:00:00 AM
Published date :
Authors :
Presenting Author: Christopher Carr, MD, MPH – Medical College of Georgia
Maanasa Javangula, BA – Medical College of Georgia
Rahul Patel, BS – Medical College of Georgia
Muhsin Quraishi, BS, BA – Medical College of Georgia
Molly Butler, MD – Medical College of Georgia
Mehul Mehra, MD – Medical College of Georgia
Debra Moore-Hill, MD, MPH – Wellstar MCG Health
Fernando Vale, MD – Medical College of Georgia
Rationale: Epilepsy is a chronic neurological disorder characterized by recurrent seizures. Patients with epilepsy face an increased risk of death that can be exacerbated by insufficient access to effective treatment. The Global Burden of Disease (GBD) is the largest investigation of global health disease burden ever conducted. We hypothesized that the lowest-income countries would have a disproportionately high burden of epilepsy.
Methods: Using GBD data, we extracted mortality and prevalence of years lived with disability (YLD) for epilepsy for every country in the world from 1990 to 2021. We abstracted gross domestic product (GDP) per capita, Healthcare Access and Quality Index (HAQI), United Nations geoscheme region (UNGR), and neurologists/neurosurgeons per capita.
Results: 17/20 (85%) countries with the highest burden of deaths due to epilepsy in 2021 were in the lowest quartile for GDP per capita (Figure 1), 13/20 (65%) were in the lowest quartile for HAQI, and 15/20 (75%) were in sub-Saharan Africa UNGRs, which were also the regions with the fewest neurologists and neurosurgeons per capita. Among the 20 countries with the highest burden of YLD due to epilepsy, 1/20 (5%) was in the highest quartile for GDP per capita, 4/20 (20%) were in the second quartile, 11/20 (55%) were in the third quartile, and 4/20 (20%) were in the lowest quartile (Figure 2). 0 were in the highest HAQI quartile, 4/20 (20%) were in the second quartile, 10/20 (50%) were in the third quartile, and 6/20 (30%) were in the lowest quartile. 10/20 (50%) countries with the highest YLD attributable to epilepsy were in sub-Saharan Africa; 10/20 (50%) were in Central America, South America, or the Caribbean UNGRs. From 1990 to 2021, 115/204 (56%) countries had a decrease in deaths attributable to epilepsy. 9/20 (45%) countries with the largest decrease were in the lowest GDP quartile, and 8/20 (40%) were in sub-Saharan Africa UNGRs. 160/204 (78%) countries had a decrease in YLD during this period. 6/20 (30%) countries with the largest decrease were in the lowest GDP quartile, 6/20 (30%) were in the third quartile, 2/20 (10%) were in the second quartile, and 6/20 (30%) were in the highest GDP quarttile. 9/20 (45%) were in Asian or Northern Africa UNGRs, 7/20 (35%) were in Central America, South America, or the Caribbean UNGRs, and 4/20 (20%) were in sub-Saharan Africa UNGRs.
Conclusions: The highest burden of death due to epilepsy was in sub-Saharan African countries in the lowest GDP per capita and HAQI quartiles. This may reflect gaps in healthcare infrastructure, including lack of access to comprehensive epilepsy care. Results for YLD were more nuanced, as increasing YLD may reflect increased incidence of disease or increased survival. Most countries had decreases in deaths and YLD during the study period. The largest decrease in deaths took place in sub-Saharan Africa UNGRs in the lowest GDP quartile. Decreases in YLD were distributed geographically among low and middle-income countries which have seen an increase in neurologists and neurosurgeons per capita over time. Our results suggest decreasing burden of epilepsy worldwide but persistent disparities and demand for specialized care.
Funding: N/A
Epidemiology