With over 65 million people affected worldwide, epilepsy is not a rare condition but a widespread neurological disorder that intersects with nearly every aspect of global health, economics, and human experience.
Key Takeaways
- Globally, around 50 million people worldwide were affected by epilepsy in 2015, according to the Global Burden of Disease Study
- In the United States, approximately 3.4 million people have active epilepsy, with about 470,000 being children under 17 years old
- The incidence rate of epilepsy is 45.9 per 100,000 person-years in high-income countries and 81.7 per 100,000 in low- and middle-income countries
- Males have a slightly higher epilepsy prevalence than females (1.14% vs. 1.11%) in the US
- Epilepsy prevalence is highest in children aged 5-17 years at 1.13% in the US
- Among US adults, epilepsy prevalence is 1.22%, higher in those 55+ years at 1.55%
- Focal seizures account for 60% of epilepsy cases, while generalized seizures are 40%
- Tonic-clonic seizures (formerly grand mal) are the most recognized, occurring in 30-40% of epilepsy patients
- Absence seizures, common in children, last 5-20 seconds and affect 10-15% of childhood epilepsy
- Traumatic brain injury causes 20% of symptomatic epilepsy cases in adults
- Stroke is the leading cause of new-onset epilepsy in people over 65, accounting for 30-50%
- Genetic mutations like SCN1A cause Dravet syndrome in 80% of cases
- 70% of people with epilepsy can become seizure-free with antiepileptic drugs (AEDs)
- Surgery achieves seizure freedom in 60-80% of mesial temporal lobe epilepsy patients
- Vagus nerve stimulation (VNS) reduces seizures by 50% in 50-60% of drug-resistant cases after 2 years
Epilepsy affects millions worldwide but can often be effectively controlled with treatment.
Causes
- Traumatic brain injury causes 20% of symptomatic epilepsy cases in adults
- Stroke is the leading cause of new-onset epilepsy in people over 65, accounting for 30-50%
- Genetic mutations like SCN1A cause Dravet syndrome in 80% of cases
- CNS infections such as neurocysticercosis cause 30% of epilepsy in endemic areas like Latin America
- Brain tumors account for 5-10% of adult-onset epilepsy cases
- Perinatal hypoxia contributes to 20-30% of cerebral palsy-associated epilepsy
- Alcohol withdrawal seizures occur in 5-15% of chronic alcoholics during detoxification
- Cortical malformations like focal cortical dysplasia cause 20-40% of pediatric surgical epilepsy
- Autoimmune encephalitis, e.g., anti-NMDA receptor, presents with seizures in 80% of cases
- Metabolic disorders like GLUT1 deficiency cause early-onset epilepsy in 1 in 25,000
- Head trauma from accidents causes epilepsy in 5% if moderate, 35-50% if severe
- Neurodegenerative diseases like Alzheimer's contribute to 10-20% of late-onset epilepsy
- Malformations of cortical development underlie 20% of intractable childhood epilepsy
- Drug-induced seizures from tramadol occur at doses over 400mg in 10% of users
- Tuberous sclerosis complex causes epilepsy in 85-90% of patients, often infantile spasms
- Hypoxic-ischemic encephalopathy leads to epilepsy in 15-20% of term neonates
- Mitochondrial disorders account for 1-2% of pediatric epilepsies with refractory seizures
- Parasitic infections like onchocerciasis cause "river blindness epilepsy" in 1-10% in Africa
- Eclampsia causes seizures in 0.5-2% of pregnancies in developing countries
- Hippocampal sclerosis is found in 60-70% of mesial temporal lobe epilepsy cases
- Binge drinking increases seizure risk 3-fold in epilepsy patients
- Angelman syndrome has epilepsy in 80-90% with atypical absence and myoclonic seizures
- Rasmussen's encephalitis causes unihemispheric seizures in children under 10
- Sleep deprivation lowers seizure threshold, precipitating 30% of seizures
- 70% of epilepsies are symptomatic/structural, 30% genetic/unknown
Causes Interpretation
While your brain may occasionally throw an unauthorized party due to trauma, stroke, or a rogue gene, remember that over two-thirds of epilepsy cases have a tangible cause, proving that chaos usually has a very logical, if unwelcome, source.
Demographics
- Males have a slightly higher epilepsy prevalence than females (1.14% vs. 1.11%) in the US
- Epilepsy prevalence is highest in children aged 5-17 years at 1.13% in the US
- Among US adults, epilepsy prevalence is 1.22%, higher in those 55+ years at 1.55%
- Women with epilepsy have higher rates of SUDEP risk factors like generalized tonic-clonic seizures
- In the US, epilepsy is more prevalent among rural residents (1.71%) than urban (1.04%)
- Non-Hispanic blacks have a 16% higher epilepsy prevalence than non-Hispanic whites in the US
- Globally, 70% of epilepsy cases occur in low- and middle-income countries affecting diverse demographics
- In the US, adults with less than high school education have 1.8% epilepsy prevalence vs. 0.7% for college graduates
- Epilepsy in children under 5 years has prevalence of 0.92% in the US
- Males account for 53% of epilepsy cases in the US
- In the UK, epilepsy affects 1 in 200 children and 1 in 100 adults over 65
- US poverty-level households have 2.3% epilepsy prevalence vs. 0.9% above poverty
- Globally, epilepsy onset is bimodal: infancy and elderly, with 25% of cases starting after age 60
- In Australia, epilepsy prevalence is higher in males (0.9%) than females (0.7%)
- US adults aged 18-24 have the lowest epilepsy prevalence at 0.77%
- Hispanic adults in the US have epilepsy prevalence of 1.13%, similar to non-Hispanic whites
- In Canada, epilepsy is more common in males, with sex ratio of 1.2:1
- Elderly women over 75 have higher stroke-related epilepsy risk than men
- In the US, epilepsy prevalence among unemployed adults is 2.4% vs. 0.9% employed
- Children with developmental disabilities have epilepsy rates up to 40%
- In low-income countries, females with epilepsy face higher stigma affecting marriage rates (50% unmarried vs. 20% general)
- US multiracial adults have highest epilepsy prevalence at 1.87%
- In India, rural females have higher epilepsy prevalence due to untreated infections
- Epilepsy in US veterans is 2-5 times higher than civilians due to TBI
- Globally, 60% of epilepsy patients are under 20 years old
Demographics Interpretation
While epilepsy may not play favorites, it certainly reveals a grim poker hand where the cards of poverty, age, location, gender, and trauma are dealt with a cruel and statistically significant bias.
Epidemiology
- Globally, around 50 million people worldwide were affected by epilepsy in 2015, according to the Global Burden of Disease Study
- In the United States, approximately 3.4 million people have active epilepsy, with about 470,000 being children under 17 years old
- The incidence rate of epilepsy is 45.9 per 100,000 person-years in high-income countries and 81.7 per 100,000 in low- and middle-income countries
- Epilepsy prevalence in the US increased from 0.9% in 2010 to 1.2% in 2015 among adults
- In Europe, the prevalence of epilepsy is estimated at 5-10 per 1,000 people
- Approximately 1 in 26 people in the United States will develop epilepsy during their lifetime
- In low- and middle-income countries, 80% of people with epilepsy live there despite only 20% of the world's population
- The annual economic cost of epilepsy in the US is estimated at $15.5 billion, including direct medical costs and indirect costs like lost productivity
- Epilepsy affects over 65 million people globally as of recent estimates
- In Canada, about 0.6% of the population or 200,000 people have epilepsy
- The prevalence of epilepsy in Australia is approximately 1 in 125 people or 0.8%
- In the UK, around 600,000 people have epilepsy, affecting 1 in 104 people
- Epilepsy incidence peaks in children under 1 year and adults over 75 years
- In sub-Saharan Africa, epilepsy prevalence can reach up to 10 per 1,000 due to parasitic infections
- Post-traumatic epilepsy occurs in 10-20% of severe traumatic brain injury cases
- Neonatal seizures occur in 1-3 per 1,000 live births in high-income countries
- In the US, epilepsy-related emergency department visits totaled 511,000 in 2012
- Lifetime prevalence of epilepsy in the US is 3%
- In China, epilepsy affects about 9 million people with a prevalence of 6.16 per 1,000
- Epilepsy contributes to 0.5% of the global disease burden measured in DALYs
- In the US, 1 in 10 people with epilepsy die before age 50
- Prevalence of epilepsy in Latin America ranges from 3.2 to 11.1 per 1,000
- In India, epilepsy prevalence is estimated at 5-10 per 1,000 population
- Epilepsy affects 1% of the population in New Zealand
- In South Korea, epilepsy prevalence is 8.0 per 1,000
- Global epilepsy incidence is 61.4 per 100,000 person-years
- In the US, disparities show higher prevalence among non-Hispanic blacks at 1.41% vs. whites at 1.15%
- Epilepsy in the elderly (over 65) accounts for 20% of new cases in high-income countries
- In rural Kenya, epilepsy prevalence is 15 per 1,000
- US hospitalization rates for epilepsy status epilepticus are 3.7 per 100,000
Epidemiology Interpretation
Epilepsy, the world’s uninvited party crasher, has rather impressively RSVP'd for over 65 million guests, yet its disproportionate havoc in poorer nations and staggering $15.5 billion U.S. price tag reveal a crisis hiding in plain sight.
Prognosis
- SUDEP risk is reduced by 2-3 fold with seizure freedom on treatment
- 65-70% of children with epilepsy outgrow seizures by adulthood
- Mortality rate in epilepsy is 2-3 times higher than general population
- SUDEP incidence is 1.2 per 1,000 patient-years in adults with epilepsy
- Post-surgical seizure freedom predicts 90% employment rate vs. 45% with ongoing seizures
- Idiopathic generalized epilepsies have 80-90% remission rate with AEDs
- In Lennox-Gastaut syndrome, only 10-20% achieve long-term seizure control
- 5-year seizure freedom after onset occurs in 70% if first two AEDs work
- Epilepsy remission before age 18 in 60-70% of childhood-onset cases
- SUDEP risk increases 20-fold with >3 generalized tonic-clonic seizures per year
- Cognitive prognosis worsens with early onset and frequent seizures in 40% of cases
- Dravet syndrome has 15-20% mortality by adulthood from SUDEP or infections
- Temporal lobectomy has 70% seizure freedom at 10 years post-surgery
- Quality of life improves by 50% with >50% seizure reduction via VNS
- West syndrome has 50% normal development if treated early, vs. 10% if delayed
- Annual SUDEP risk in children is 0.2 per 1,000, lower than adults
- 20-30% relapse rate after AED withdrawal in seizure-free patients >2 years
- In tuberous sclerosis, mTOR inhibitors improve developmental prognosis in 60%
- Epilepsy contributes to 13% of sudden unexpected deaths in the young
- Prognosis better in genetic epilepsies (80% control) vs. structural (50%)
Prognosis Interpretation
While the grim statistics remind us that epilepsy remains a formidable adversary, the profound power of effective treatment—from medication to surgery—offers a clear path to drastically reclaim life, liberty, and the pursuit of happiness for the majority.
Treatment
- 70% of people with epilepsy can become seizure-free with antiepileptic drugs (AEDs)
- Surgery achieves seizure freedom in 60-80% of mesial temporal lobe epilepsy patients
- Vagus nerve stimulation (VNS) reduces seizures by 50% in 50-60% of drug-resistant cases after 2 years
- Ketogenic diet controls seizures in 50% of children with refractory epilepsy, 30% seizure-free
- Responsive neurostimulation (RNS) reduces seizures by 70% after 9 years in focal epilepsy
- First-line AEDs like levetiracetam control seizures in 47% of new-onset cases
- Laser interstitial thermal therapy (LITT) achieves 55-65% seizure freedom in hypothalamic hamartomas
- Cannabidiol (Epidiolex) reduces drop seizures by 40% in Lennox-Gastaut syndrome
- Corpus callosotomy reduces drop attacks by 50-90% in atonic seizure patients
- Monotherapy with lamotrigine is effective in 40-60% of focal epilepsies
- Deep brain stimulation (DBS) of anterior thalamus reduces seizures by 69% at 7 years
- Modified Atkins diet shows 50% seizure reduction in 40% of adults with epilepsy
- Status epilepticus is terminated with benzodiazepines in 80% of out-of-hospital cases
- Everolimus reduces seizures by 40% in tuberous sclerosis complex patients
- Hemispherectomy achieves 80-90% seizure freedom in infantile hemispheric syndromes
- Cenobamate achieves seizure freedom in 21% of highly refractory focal epilepsy patients
- Low glycemic index treatment diet reduces seizures in 50% of pediatric cases
- Stiripentol with valproate/clobazam reduces seizures by 70% in Dravet syndrome
- Fenfluramine reduces seizures by 75% in median for Dravet syndrome
- Brivaracetam shows 40% responder rate in focal seizures similar to levetiracetam
- ACTH therapy controls infantile spasms in 85% initially, but relapse in 30-50%
- Perampanel reduces focal seizures by 30-40% as adjunctive therapy
- 30% of epilepsy patients remain drug-resistant despite multiple AED trials
Treatment Interpretation
The statistical landscape of epilepsy reveals a hopeful but tiered reality: while the majority can find freedom with medication, a persistent arsenal of advanced and sometimes niche interventions stands ready to battle for those who don't, proving resilience is as much a part of the data as the seizures themselves.
Types
- Focal seizures account for 60% of epilepsy cases, while generalized seizures are 40%
- Tonic-clonic seizures (formerly grand mal) are the most recognized, occurring in 30-40% of epilepsy patients
- Absence seizures, common in children, last 5-20 seconds and affect 10-15% of childhood epilepsy
- Myoclonic seizures involve brief jerks and are characteristic of juvenile myoclonic epilepsy in 90% of cases
- Atonic seizures, or drop attacks, occur in Lennox-Gastaut syndrome in 75% of patients
- Febrile seizures affect 2-5% of children under 5, mostly simple type lasting under 15 minutes
- Status epilepticus, lasting over 5 minutes, occurs in 10-20% of first seizures in adults
- Gelastic seizures from hypothalamic hamartomas cause laughter in 95% of cases
- Infantile spasms, a type of epileptic encephalopathy, peak at 4-7 months and affect 1 in 2,000-4,000 infants
- Focal aware seizures (simple partial) preserve consciousness and last under 2 minutes in 50% of focal epilepsies
- Clonic seizures feature rhythmic jerking and are common in symptomatic generalized epilepsies
- Tonic seizures stiffen muscles and occur mainly at night in 70% of cases in Dravet syndrome
- Reflex seizures are triggered by stimuli in 5-10% of epilepsy patients, like photosensitive in 0.5%
- Non-convulsive status epilepticus accounts for 20-30% of status epilepticus cases, often missed
- Hypermotor seizures involve vigorous movements and are typical of frontal lobe epilepsy in 80% cases
- Automatisms like lip smacking occur in 60-80% of temporal lobe seizures
- Epileptic spasms in West syndrome respond to ACTH in 70-80% initially
- Versive seizures with head turning are focal and lateralize to contralateral hemisphere in 90%
- Ictal asystole occurs in 0.2-0.5% of temporal lobe epilepsy patients during seizures
- Focal impaired awareness seizures evolve from aware ones in 70% of temporal lobe cases
- Bilateral tonic-clonic seizures from focal onset spread in 60% of cases
- Photosensitive epilepsy affects 0.5-1% of general population, mostly adolescent females
- Musicogenic seizures triggered by specific music occur in <1% of temporal lobe epilepsies
- Aura precedes seizures in 50-60% of focal epilepsies, like epigastric rising sensation
Types Interpretation
This vivid statistical mosaic reveals epilepsy not as a monolithic condition, but rather as a sprawling collection of electrical uprisings, each with its own favorite targets, signature moves, and alarming frequencies, reminding us that the brain's occasional rebellion takes many surprisingly specific forms.
Sources & References
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- Reference 13FDAfda.govVisit source