Global, regional, and national epidemiology of childhood epilepsy from 1990 to 2021: a systematic study based on the GBD 2021

Epilepsy is a major chronic neurological disorder in children, causing significant global disease burden due to neurodevelopmental impairments and socioeconomic impacts. This study assesses global childhood epilepsy trends (1990–2021), focusing on incidence, mortality, disability-adjusted life years (DALYs), risk factors, and regional disparities. Using Global Burden of Disease Study 2021 data, this cross-sectional analysis evaluated epilepsy epidemiology among children aged 0–14 across 204 regions. Incidence, mortality, DALYs, and estimated annual percentage changes (EAPCs) were stratified by geography, demographics, and Socio-demographic Index (SDI).In 2021, global childhood epilepsy incidence rose to 1,227,191 cases (26.34% increase since 1990), with incidence rates climbing from 55.85 to 61.00 per 100,000. Mortality and DALYs declined by 29.5% (1.48 to 0.90 per 100,000) and 14.89% (EAPC: −1.39 and − 0.94), respectively. Low SDI regions showed the highest mortality (1.46 per 100,000) and DALYs (244.53 per 100,000), while high SDI regions had the highest incidence (70.66 per 100,000). Ecuador (120.09 per 100,000) and Tajikistan (2.77 per 100,000) reported extreme incidence and mortality rates. Key mortality risks included alcohol consumption and behavioral factors (15% each). Despite declining mortality and DALYs, childhood epilepsy incidence continues to rise globally, highlighting persistent disparities.