Global, regional and national burden of epilepsy in adolescents aged 10-19 years from 1990 to 2021: An analysis for the Global Burden of Disease Study 2021.

OBJECTIVE: Epilepsy, a neurological disorder characterized by recurrent seizures, imposes multidimensional burdens on adolescents aged 10-19 years, including disrupted education, restricted social participation, and diminished socioeconomic prospects. The aim of this study is to analyze global disparities in adolescent epilepsy burden through cross-national comparisons based on global burden of disease (GBD) data, identifying evidence-based strategies from low-burden countries (e.g., tiered care frameworks, stigma-reduction initiatives) to optimize targeted intervention policies. METHODS: We quantified the global burden of adolescent epilepsy (ages 10-19) across 204 countries (1990-2021), measuring deaths, prevalence, and disability-adjusted life years (DALYs), stratified by sex, year, location, and sociodemographic index (SDI), with 95% uncertainty intervals (UIs). RESULTS: In 2021, 4.37 (95% UI 2.85-6.21) million adolescents aged 10-19 years lived with epilepsy, corresponding to 338.90 (95% UI 220.72-481.65) per 100 000. The burden increased worldwide, yet exhibited regional disparities: Western Europe, North America, and East Asia demonstrated lower prevalence than sub-Saharan Africa. Age-standardized DALY rates inversely correlated with SDI across regions. The age-standardized DALY rates showed sex-based differences in some regions. SIGNIFICANCE: Global adolescent epilepsy burden exhibited stagnant temporal trends (1990-2021) with pronounced geospatial heterogeneity. However, some countries exhibited paradoxically high DALYs alongside low prevalence, potentially reflecting diagnostic capacity. Case analyses of low-burden exemplars revealed three mitigation pillars: (1) integrated school-based seizure detection systems, (2) decentralized antiepileptic drug distribution networks, and (3) community stigma-reduction campaigns. These evidence-based strategies demonstrated scalable potential for reducing diagnostic delays and sociodemographic disparities, particularly in resource-constrained regions through adaptive implementation of mobile telemedicine and tiered referral protocols. PLAIN LANGUAGE SUMMARY: This study found that epilepsy affects millions of teens worldwide, with higher rates in poorer regions due to limited healthcare and stigma. Countries like China reduced cases through better treatment access and education, while areas like Africa struggled with conflicts and weak health systems. Boys face worse outcomes than girls, partly due to delayed care. Solutions include training local doctors, community education, and affordable medicines to help teens live healthier lives.