Global, regional, and national epidemiology of childhood epilepsy from 1990 to 2021: a systematic study based on the GBD 2021

Background

Epilepsy is one of the most prevalent chronic neurological disorders in children, imposing a substantial global disease burden characterized by neurodevelopmental impairments, premature mortality, and heightened socioeconomic costs. This study aimed to evaluate the global incidence, mortality, and disability-adjusted life years (DALYs) associated with childhood epilepsy from 1990 to 2021, identify key risk factors, and assess differences between regions and countries, while also predicting the global disease burden associated with childhood epilepsy up to 2035.

Method

This epidemiological analysis utilized cross-sectional data from the Global Burden of Disease Study 2021 (GBD 2021) to systematically investigate childhood epilepsy trends among individuals aged 0–14 years across 204 global jurisdictions over the period 1990–2021. The study employed a comprehensive analytical framework to assess disease incidence, mortality, and DALYs, alongside their estimated annual percentage changes (EAPCs). Stratification was performed based on geographical distribution, national boundaries, demographic variables (age and sex), and the Socio-demographic Index (SDI). Forecasting of childhood epilepsy trends until 2035 utilized the Autoregressive Integrated Moving Average (ARIMA) model.

Results

In 2021, the incident number of global childhood epilepsy reached 1227,191 cases (26.3 % increase since 1990), with an incidence rate rising from 55.9 to 61.0 per 100,000. Mortality declined by 29.5 % (1.5 to 0.9 per 100,000), and DALYs decreased by 14.9 % (EAPC: −1.39 and −0.94, respectively). Socioeconomic disparities were pronounced: low SDI regions had the highest mortality (1.5 per 100,000) and DALYs (244.5 per 100,000), while high SDI regions reported the highest incidence (70.7 per 100,000). Ecuador (120.1 per 100,000) and Tajikistan (2.8 per 100,000) recorded the highest incidence and mortality rates, respectively. The only risk factor for epilepsy-related deaths is high alcohol consumption, accounting for 15.0 %. Projections for 2035 anticipate increased childhood epilepsy cases alongside further deaths and DALYs declines.

Conclusion

Childhood epilepsy remains a growing global health concern, with an increasing incidence despite ongoing declines in mortality and DALYs. Although advancements in healthcare have contributed to reduced epilepsy-related deaths and DALYs over time, the absolute burden of this neurological disorder remains substantial, particularly in pediatric populations, with significant regional differences. These findings underscore the urgent need to enhance early screening programs and improve the accessibility of antiepileptic medications, especially in low SDI regions.