Global and Regional Trends in the Burden of Epilepsy in Adolescents (0-19 Years) from 1990 to 2023: A Comprehensive Analysis of Incidence, Prevalence, Mortality, and DALYs by Sex and Socio-Demographic Index

Background Epilepsy represents a significant neurological burden among adolescents globally, yet comprehensive analyses of temporal trends and regional disparities remain limited. Objective This study aimed to assess the global, regional, and national burden of epilepsy among adolescents aged 0–19 years from 1990 to 2023. Methods Data were extracted from the Global Burden of Disease Study 2023, analyzing incidence, prevalence, disability-adjusted life years (DALYs), and mortality rates across 204 countries and territories. Age-standardized rates were calculated using the Global Burden of Disease (GBD) 2019 world standard population. Estimated annual percentage changes (EAPCs) were computed to quantify temporal trends, and decomposition analysis identified contributing factors to burden changes. Results Global age-standardized incidence rates declined modestly from 62.3 per 100,000 (95% UI: 51.2, 75.1) in 1990 to 58.7 per 100,000 (95% UI: 48.6, 70.8) in 2023 (EAPC: -0.21%). Low-SDI regions experienced burden rates 2.8 times higher than high-SDI regions. Males consistently demonstrated higher burden across all metrics, with incidence rates 1.23 times higher than females. Western Sub-Saharan Africa reported the highest incidence (112.6 per 100,000), while High-income Asia Pacific showed the lowest (28.9 per 100,000). Children under 5 years accounted for 42–48% of incident cases globally. Conclusion Despite overall declining trends, substantial regional and socioeconomic disparities persist in adolescent epilepsy burden, with low-income regions and males disproportionately affected. Targeted interventions addressing healthcare access inequities are essential.