Introduction: Epilepsy is one of the most common global neurological disorders, yet its disease burden is still inadequately characterized. Numerous data on regional trends have become available recently. We sought to compile this regional data to quantify global prevalence and incidence of epilepsy. Understanding regional and global epilepsy epidemiology is crucial for diagnosis, treatment, and resource allocation.
Methods: We performed a systematic literature review and meta-analysis to calculate the global prevalence and incidence of epilepsy, and by World Health Organization region and World Bank Income Level. We extracted data from all population-based studies worldwide, from 1990-2016.
Results: Our systematic review yielded 167 articles, inclusive of all WHO regions and income levels. The raw global prevalence of lifetime epilepsy is 1098.5 per 100,000 people, while active epilepsy is slightly lower at 690.1 per 100,000 people. Global incidence is estimated at 61.6 cases per 100,000 person-years. Our meta-analysis predicts 4.6 million new cases of epilepsy every year worldwide, and 51.7 million people with active epilepsy. The highest estimated prevalence is found in Africa and Latin America, although the highest incidence is reported in the Middle East and Latin America. These regions are primarily comprised of low- and middle- income countries by World Bank categorization, making the highest disease burden fall disproportionately on regions with the fewest healthcare resources.
Conclusions: Our understanding of the global epidemiology of epilepsy has evolved as more regions have been studied. This up-to-date worldwide analysis provides the most comprehensive picture yet of current trends in epilepsy prevalence and incidence. The preferential distribution of this disease in LMIC may require targeted efforts in diagnosis and treatment to reduce the global disparities in care and cost. Quantifying global epilepsy provides the first step towards facilitating allocation and redirection of healthcare resources to those regions with higher burdens and decreased access to appropriate care.
Patient Care: This global assessment of epilepsy epidemiology provides crucial data for caring for epilepsy patients across the globe. These data can help improve resource allocation for diagnosis and treatment of epilepsy to highly affected regions with limited access to care.
Learning Objectives: To understand the global disease burden and epidemiology of epilepsy.
References: see manuscript reference list