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Comparative Study
. 2025 Apr 10;96(5):480-488.
doi: 10.1136/jnnp-2024-334547.

Prevalence of epilepsy: a population-based cohort study in Denmark with comparison to Global Burden of Disease (GBD) prevalence estimates

Jakob Christensen  1   2 , Betina B Trabjerg  3   4 , Ryan G Wagner  5 , Charles R Newton  6   7 , Churl-Su Kwon  8 , Kari Modalsli Aaberg  9 , Eugen Trinka  10   11   12 , Samuel Wiebe  13 , Judith Helen Cross  14 , Håkon Magne Vegrim  15 , Theo Vos  16 , Jaimie Steinmetz  16 , Julie Werenberg Dreier  3   4
Affiliations
Comparative Study

Prevalence of epilepsy: a population-based cohort study in Denmark with comparison to Global Burden of Disease (GBD) prevalence estimates

Jakob Christensen et al. J Neurol Neurosurg Psychiatry. .

Abstract

Background: The Global Burden of Disease Study (GBD) produces prevalence estimates for 'idiopathic epilepsy' (ie, of unknown aetiology) and 'secondary epilepsy' (ie, with known aetiology) but does not report prevalence by underlying aetiologies for 'secondary epilepsy'.

Methods: We used nationwide, population-based register data from Denmark to identify underlying causes of epilepsy and their contribution to prevalence of 'secondary epilepsy' and compared with global prevalence data from GBD 2019. We identified all persons with a hospital-based epilepsy diagnosis and a filled prescription for antiseizure medication between 1 January 2009 and 31 December 2018. Epilepsy was categorised into 'idiopathic' or 'secondary' and 'total epilepsy' as the sum of the two epilepsy categories.

Results: On 31 December 2018, a total of 5 784 284 individuals (49.7% males) were living in Denmark including 40 336 with epilepsy (51.5% males). Perinatal conditions, traumatic brain injury, brain tumours and stroke were prominent underlying causes of 'secondary epilepsy'. The prevalence of 'total epilepsy' in Denmark was 697 (95% CI 691 to 704) per 100 000 population (264 (95% CI 260 to 269) for 'secondary epilepsy' and 433 (95% CI 428 to 438) for 'idiopathic epilepsy'). In the GBD 2019 Study, the prevalence of 'total epilepsy' in 2018 was 682 (95% uncertainty interval (UI) 586 to 784) per 100 000 population (359 (95% UI 324-397) for 'secondary epilepsy' and 324 (95% UI 249 to 404) for 'idiopathic epilepsy').

Conclusions: Prevalence estimates of 'total epilepsy', 'idiopathic epilepsy' and 'secondary epilepsy' in Denmark align with the GBD 2019 estimates. In future studies, it is suggested to explicitly include all types of epilepsy, including 'secondary epilepsy', which is currently estimated as sequelae (consequences) of underlying diseases.

Keywords: DEMENTIA; EPIDEMIOLOGY; EPILEPSY; STROKE.

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Conflict of interest statement

Competing interests: JC has received honoraria from serving on the scientific advisory board of UCB Nordic and Eisai AB, received honoraria for giving lectures from UCB Nordic and Eisai AB and received funding for a trip from UCB Nordic. ET has received personal honoraria for lectures, and educational from EVER Pharma, Marinus, Arvelle, Angelini, Argenx, Medtronic, Biocodex, Bial-Portela & Ca, NewBridge, GL Pharma, GlaxoSmithKline, Boehringer Ingelheim, LivaNova, Eisai, Epilog, UCB, Biogen, Sanofi, Jazz Pharmaceuticals, Actavis, grant from Biogen, UCB Pharma, EisaiRed Bull, Merck, Bayer, The European Union, FWF Osterreichischer Fond zur Wissenschaftsforderung Bundesministerium für Wissenschaft und Forschung and Jubiläumsfond der Österreichischen Nationalbank. SW received consulting fees from Paladyn Labs, speaker fees from Torrent Pharma. JHC received to institution grants from Zogenix/UCB, Stoke Therapeutics and Ultragenyx, consulting fees from Takeda, Biocodex, honoraria for lectures from Biocodex, UCB, Jazz Pharmaceuticals, Nutricia, payment for expert testimony from Jazz Pharmaceuticals, payment for participation on a Data Safety Monitoring Board or Advisory Board from Stoke Therapeutics, and leadership as President ILAE, Chair medical board Matthews Friends, Chair Medical Board H4H, Chair executive committee INKS. JS received a salary from a GBD-wide grant to conduct GBD analyses from Bill & Melinda Gates Foundation.

Figures

Figure 1
Figure 1. Age-specific point prevalence of ‘secondary epilepsy’ (with known aetiology) and ‘idiopathic epilepsy’ (with unknown aetiology) in Denmark on 31 December 2018. Prevalence estimates are estimated for the age groups <10 years, 10–14, 15–19, …, 80–84, 85–89 and 90+ years (see tables1 2 for more detailed age-specific and sex-specific prevalence estimates).
Figure 2
Figure 2. Age-specific point prevalence (top) (A) and proportions (bottom) of ‘idiopathic epilepsy’ (with unknown aetiology) and ‘secondary epilepsy’ (with known aetiology) (B) by underlying cause of epilepsy in Denmark on 31 December 2018. Prevalence estimates and proportions are estimated for the age groups <10 years, 10–14, 15–19, …, 80–84, 85–89 and 90+ years. Only diagnoses given before the first epilepsy diagnosis are considered for preceding causes (not counting infections, traumatic brain injuries and strokes if occurring within the 14 days prior to first epilepsy diagnosis). In case of multiple diagnoses before onset of epilepsy, the one occurring closest to the first epilepsy diagnosis was chosen. ‘Idiopathic’ indicates epilepsy with unknown aetiology. ‘Malformations’ are grouped with ‘idiopathic’ for age groups 80 years and above due to small numbers. ‘Dementia’ is grouped with ‘stroke’ for age groups below 60 years due to small numbers. The Danish Hospital Register was established in 1977 and is not able to identify birth related and perinatal conditions as causes of epilepsy in persons over 41 years of age because these persons were born before the register was established. Numbers are given in online supplemental table 2.
Figure 3
Figure 3. Age-specific point prevalence of ‘secondary epilepsy’ (with known aetiology) and ‘idiopathic epilepsy’ (with unknown aetiology) in the 2019 Global Burden of Epilepsy Study for the year 2018. Prevalence estimates are estimated for the age groups <10 years, 10–14, 15–19, …, 80–84, 85–89 and 90+ years. Global epilepsy estimates are obtained from the Global Burden of Disease (Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2019 (GBD 2019) Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME), 2020. Available from https://vizhub.healthdata.org/gbd-results/.
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