Epidemiology and Management of Epilepsy in Diverse Populations

Epilepsy affects more than 50 million people worldwide, with marked variation in incidence, prevalence and outcomes between regions and social groups. In high-income countries, the prevalence of active epilepsy typically ranges from 4 to 8 per 1 000 people, whereas in low- and middle-income settings it may exceed 15 per 1 000, particularly in rural areas with limited access to healthcare. Risk factors such as perinatal injury, central nervous system infections and head trauma underpin much of the excess burden in resource-constrained environments. Mortality among people with epilepsy is elevated two- to seven-fold compared to the general population, driven by uncontrolled seizures, status epilepticus and sudden unexpected death in epilepsy. Management relies principally on antiseizure medications, yet up to two-thirds of individuals in some regions do not receive adequate treatment owing to cost, distance from facilities, stigma and cultural beliefs. Emerging strategies to narrow this treatment gap include community education, task-sharing with non-specialist providers, simplified treatment algorithms and supply-chain innovations. Advances in epidemiological methods, such as multi-stage screening and data linkage, are refining burden estimates and guiding resource allocation. An integrated approach—encompassing prevention of aetiological triggers, timely diagnosis, affordable medication access and social support—is essential to reduce the unequal impact of epilepsy across diverse populations.

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Epidemiology and Management of Epilepsy in Diverse Populations publication trend

The graph below shows the total number of articles in epidemiology and management of epilepsy in diverse populations across all publications each year (not limited to Nature Index journals).

Technical terms

Antiseizure medications (ASMs): Drugs used to prevent or reduce the frequency of epileptic seizures.

Active convulsive epilepsy (ACE): Recurrent convulsive seizures occurring within a specified recent period, indicating ongoing disease activity.

Treatment gap: The proportion of individuals with epilepsy who require but do not receive appropriate medical treatment.

Incidence: The rate at which new cases of epilepsy develop in a population over a defined time frame.

Prevalence: The total number of epilepsy cases—both new and existing—present in a population at a given time.

Standardised mortality ratio (SMR): A comparison of observed deaths among people with epilepsy to the number expected based on general population rates.

Sudden unexpected death in epilepsy (SUDEP): Sudden, unanticipated death in a person with epilepsy that is not due to trauma, drowning or other known causes.

References

1. Prescription patterns and therapeutic gaps among persons with epilepsy in Southwestern Nigeria. Frontiers in Pharmacology (2024).
2. Prevalence, incidence, and trends of epilepsy among children and adolescents in Africa: a systematic review and meta-analysis. BMC Public Health (2024).
3. Premature mortality of epilepsy in low‐ and middle‐income countries: A systematic review from the Mortality Task Force of the International League Against Epilepsy. Epilepsia (2016).
4. Estimation of the burden of active and life‐time epilepsy: A meta‐analytic approach. Epilepsia (2010).
5. Prevalence of active convulsive epilepsy in sub-Saharan Africa and associated risk factors: cross-sectional and case-control studies. The Lancet Neurology (2013).
6. Risk factors associated with the epilepsy treatment gap in Kilifi, Kenya: a cross-sectional study. The Lancet Neurology (2012).
7. The validation of a three-stage screening methodology for detecting active convulsive epilepsy in population-based studies in health and demographic surveillance systems. Emerging Themes in Epidemiology (2012).